A caregiver who works in the hospital brings his 9-year-old son to the emergency room with a spiral fracture of the tibia. The caregiver reports that the injury occurred when the boy’s 5-year-old sister hit him with a wooden bat. The injury is inconsistent with an impact and with the sister’s strength. Which of the following would be appropriate for the nurse to do in this situation?

Choice A reason: Removing equipment reduces clutter but is less urgent than preventing falls, especially post-procedure when a child may be disoriented. Ensuring side rails and a low bed prioritizes safety, making this secondary and incorrect for the most immediate action in pediatric post-procedure care.

Choice B reason: Handling contaminated linens follows infection control but is not the immediate safety concern post-procedure. Preventing falls with side rails and a low bed is critical, making this less urgent and incorrect compared to the priority of ensuring the child’s physical safety after the procedure.

Choice C reason: Assessing side rails up and bed lowered prevents falls, the most immediate safety risk post-procedure when a child may be sedated or unsteady. This aligns with pediatric safety protocols, making it the correct statement for the most urgent action in post-procedure interventions.

Choice D reason: Documentation is essential but not immediate compared to fall prevention, which protects the child post-procedure. Side rails and bed positioning take precedence, making this subsequent and incorrect for the most urgent safety action required after a pediatric procedure in the hospital.

Choice A reason: Socializing with healthy peers may motivate but doesn’t directly teach self-care skills for chronic illness. A contract with rewards engages the child actively, making this less focused and incorrect compared to a structured strategy ensuring school-aged children achieve treatment goals effectively.

Choice B reason: Co-writing a contract with rewards engages the child in setting and achieving self-care goals, fostering responsibility and motivation. This aligns with pediatric chronic illness management, making it the most effective strategy to help school-aged children master treatment goals with caregiver involvement.

Choice C reason: Reinforcing the importance of goals educates but lacks active engagement compared to a reward-based contract. Contracts promote accountability, making this less effective and incorrect for directly helping chronically ill children achieve self-care treatment goals in a structured, motivating way.

Choice D reason: A sticker chart tracks progress but is less collaborative than a contract, which involves the child in goal-setting. Contracts better foster ownership, making this less engaging and incorrect compared to the co-written contract strategy for achieving self-care goals in school-aged children.