A 10-year-old child with a distal femoral fracture involving the growth plate is admitted for treatment. Which nursing action should be prioritized to prevent long-term complications related to growth disturbances?
instruct the child to avoid weight-bearing activities indefinitely to prevent fracture displacement.
Assure the parents that damage to the growth plate will not affect the length or shape of the child's limb.
Explain that the fracture will heal at the same rate as an adult fracture regardless of age or growth plate involvement.
Educate the family on the importance of follow-up visits for growth assessment and early detection of limb length discrepancies.
The Correct Answer is D
A. Instruct the child to avoid weight-bearing activities indefinitely is incorrect because prolonged immobilization is unnecessary and can lead to muscle atrophy and delayed functional recovery. Weight-bearing should be restricted only as medically indicated during the initial healing phase.
B. Assure the parents that damage to the growth plate will not affect the length or shape of the child's limb is incorrect because growth plate (physeal) fractures can lead to limb length discrepancies or angular deformities if not properly monitored. Providing false reassurance could delay necessary interventions.
C. Explain that the fracture will heal at the same rate as an adult fracture regardless of age or growth plate involvement is incorrect because pediatric fractures involving the growth plate may have unique healing patterns and potential complications, including growth disturbances.
D. Educate the family on the importance of follow-up visits for growth assessment and early detection of limb length discrepancies is correct because distal femoral physeal fractures carry a high risk for growth disturbances, including limb shortening or angular deformities. Regular follow-up with imaging and growth monitoring allows early identification and intervention, minimizing long-term functional and cosmetic complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Painful, enlarged lymph nodes is incorrect because in Hodgkin disease, the lymph node enlargement is usually painless. Painful nodes are more commonly associated with infections or inflammatory conditions, where the immune response triggers tenderness and discomfort. In Hodgkin disease, the cancerous lymphocytes infiltrate the nodes without causing acute inflammatory pain.
B. Enlarged, firm, nontender lymph nodes is correct. The classic presentation of Hodgkin disease is the presence of firm, rubbery, nontender lymphadenopathy, most often in the cervical, supraclavicular, or mediastinal regions. The nodes are typically mobile early in the disease but may become fixed as the disease progresses. This type of lymphadenopathy is usually gradual and persistent, often discovered incidentally by the patient or during a routine exam. The nontender nature is a key distinguishing feature from infectious lymphadenopathy.
C. Petechiae is incorrect because petechiae result from thrombocytopenia or coagulation disorders, not Hodgkin disease. While advanced Hodgkin lymphoma may eventually affect the bone marrow and platelet production, petechiae are not an early or common manifestation.
D. Bone and joint pain is incorrect because this is not a typical presenting symptom of Hodgkin disease. Bone involvement may occur only in advanced stages, usually with other systemic symptoms.
Correct Answer is D
Explanation
A. Prevent the return of oxygenated blood to the lungs is incorrect because closing the ductus arteriosus does not block pulmonary venous return. Blood still returns from the lungs to the left atrium and ventricle normally.
B. Decrease the edema in the legs and feet is incorrect because peripheral edema is not directly related to a patent ductus arteriosus (PDA). Edema is more associated with congestive heart failure or systemic venous congestion, which may be secondary but is not the immediate effect of surgical closure.
C. Stop the loss of unoxygenated blood to the systemic circulation is partially correct in theory, as a PDA can allow blood to shunt from the aorta to the pulmonary artery, but the key concern is left-to-right shunting of oxygenated blood back to the lungs, not unoxygenated blood going systemically.
D. Increase the oxygenation of blood is correct because surgical closure of a PDA eliminates the abnormal shunt that allows oxygenated blood from the aorta to flow back into the pulmonary circulation. This reduces pulmonary overcirculation and ensures that oxygenated blood remains in the systemic circulation, improving overall tissue oxygenation.
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