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Moderate level of pain: Pain is expected after a fracture and casting. However, if pain is severe and unrelieved by medication, it may indicate compartment syndrome, which is an emergency. Moderate pain alone does not require immediate provider notification.

Dependent edema distal to the cast: Some swelling is expected due to reduced mobility and gravity-dependent positioning. Elevating the leg can help reduce swelling, but it does not require immediate provider notification.

Itching of the distal foot: Itching is a common, non-emergency side effect of casting. Clients should be advised not to insert objects inside the cast to relieve itching.

Encourage the patient to cross their legs while dressing to reduce strain on the hip joint: Crossing the legs after hip surgery increases the risk of hip dislocation by placing excessive stress on the hip joint. This is incorrect and unsafe.

Allow the patient to continue dressing independently to promote mobility: While encouraging independence is important, allowing the patient to continue this action violates hip precautions (no bending past 90°). The patient must be stopped to prevent complications.

Instruct the patient to bend forward slowly and use both hands to pull up the socks. Bending forward, even slowly, violates hip precautions and increases the risk of dislocation. The patient should use adaptive devices, such as a sock aid, instead.

Apply an ice pack to the casted leg: Ice packs help with swelling and pain but are not the priority over assessing for neurovascular compromise.

Provide reassurance to the client and parents. Providing reassurance is important for emotional support but does not take priority over ensuring proper blood flow and nerve function in the affected limb.

Explain the discharge instructions to the client and parents. Teaching is essential but should be done after confirming that the limb is not at risk for serious complications.

Increased oral temperature from 36.6° C (97.8° F) to 37° C (98.6° F). A slight temperature increase is expected post-injury due to normal inflammatory response and does not indicate a serious complication.

Increased heart rate from 68 to 72/min. This small increase in heart rate is not clinically significant and does not indicate a serious complication.

Increased blood pressure from 112/68 to 120/72 mm Hg. This small increase in blood pressure is not alarming and does not indicate a serious complication.

Increased hip range of motion and absence of pain. A hip dislocation causes severe pain and reduced mobility, not increased range of motion. This option is incorrect.

Ability to bear weight on the affected leg without discomfort. A hip dislocation causes severe pain and functional impairment, making weight-bearing extremely difficult or impossible.

Symmetric leg length with normal alignment. A dislocated hip causes the affected leg to appear shortened and externally rotated, so symmetrical leg length would not be expected.

"This procedure determines the extent of joint damage." This describes diagnostic procedures like arthroscopy, not arthroplasty.

"This procedure will fuse my joint to reduce my pain." This describes joint fusion (arthrodesis), not joint replacement (arthroplasty).

"This procedure will prevent further joint damage.": Arthroplasty does not prevent further joint damage but replaces the joint.

"Skeletal traction has less risk for infection than skin traction." Skeletal traction involves pins and has a higher infection risk than skin traction.

"Clients with skin traction have more discomfort than those with skeletal traction." Skeletal traction is usually more painful due to pins inserted into the bone.

"Skin traction is primarily used for long-term stabilization of fractures." Skin traction is typically used short-term before surgery.

Vitamin E: Vitamin E supports immune function but is not essential for wound healing.

Folate: Folate is essential for red blood cell production but not directly for wound healing.

Vitamin B1: Vitamin B1 supports nerve function, not wound healing.

Hematocrit 40%: A hematocrit level of 40% is within the normal range for adult females (36%-48%) and does not require intervention.

Potassium 3.8 mEq/L: Normal potassium levels range from 3.5-5.0 mEq/L, so a value of 3.8 mEq/L is within normal limits and does not pose a risk for surgery.

Creatinine 0.9 mg/dL: Normal creatinine levels for adult females are 0.5-1.1 mg/dL. A level of 0.9 mg/dL indicates normal kidney function and does not require reporting.

Teach relaxation breathing to reduce the client’s pain. Pain management is important, but it does not address the underlying cause of osteomyelitis. Treating the infection is the priority.

Increase the client’s protein intake. A high-protein diet can promote healing, but it does not directly treat the infection and is not the priority intervention.

Provide the client with antipyretic therapy. Fever management is beneficial, but treating the underlying infection with antibiotics is more important than simply reducing fever.