A newborn is admitted with a diagnosis of a spiral fracture of the right femur. The mother states the child received the injury when the baby fell off the changing table. Which would be the priority nursing intervention?
Call the child abuse hotline
Educate the mother on safety
Inform the mother to call the nurse for all diaper changes
Complete the Morse Fall Scale
The Correct Answer is A
A. Call the child abuse hotline. A spiral fracture, especially in a non-ambulatory infant, is highly suspicious for non-accidental trauma (child abuse). Reporting suspected abuse is mandatory to protect the child from further harm.
B. Educate the mother on safety. While important for prevention, addressing potential abuse takes precedence.
C. Inform the mother to call the nurse for all diaper changes. This does not address the immediate concern of suspected child abuse.
D. Complete the Morse Fall Scale. This is irrelevant in the context of suspected child abuse.
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Related Questions
Correct Answer is ["B","C","E"]
Explanation
A. Stand directly in front of the client when talking: Standing directly in front of an agitated client can be seen as confrontational and might escalate the situation. It is better to stand at an angle and maintain a non-threatening posture.
B. Avoid wearing necklaces during client care: Wearing necklaces or other loose accessories can pose a safety risk if a client becomes aggressive and tries to grab or pull them, potentially causing injury.
C. Provide immediate verbal feedback for escalating behavior: Immediate feedback can help de-escalate potentially aggressive behavior by addressing issues before they become more serious. It also reinforces appropriate behavior and sets clear boundaries.
D. Bring security with you for all client interactions: Bringing security for all interactions is impractical and can create an atmosphere of distrust. Security should be involved only when there is a credible risk of violence.
E. Review the layout of the facility: Understanding the layout of the facility, including exits and potential hazards, helps in planning for safe interactions and knowing escape routes if a situation escalates.
Correct Answer is D
Explanation
A. Wash the cord daily with mild soap and water. Incorrect because keeping the area dry is crucial; soap can irritate the area.
B. Cover the cord with the diaper. Incorrect because it may trap moisture and cause irritation or infection.
C. Apply petroleum jelly to the cord stump. Incorrect because this may keep the area too moist and prevent it from drying and falling off naturally.
D. Give a sponge bath until the cord stump falls off. This prevents the cord from getting wet, which can increase the risk of infection and delay drying and detachment.
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