A nurse is assessing a child who has multiple closed fractures of the lower extremities due to a motor-vehicle crash. The nurse should monitor the child for which of the following complications during the first 24 hr after the injury occurred?
Compartment syndrome
Osteomyelitis
Renal calculi
Volkmann ischemic contracture
The Correct Answer is A
A. Compartment syndrome: Compartment syndrome is a serious and potentially life-threatening complication that can occur within the first 24 hours after fractures. It results from increased pressure within a muscle compartment, leading to decreased perfusion, pain, swelling, and neurovascular compromise, and requires prompt recognition and intervention.
B. Osteomyelitis: Osteomyelitis, a bone infection, typically develops over days to weeks after an injury or surgery. It is unlikely to occur within the first 24 hours following closed fractures, making it a less immediate concern during initial assessment.
C. Renal calculi: Renal calculi are kidney stones that develop over time due to metabolic or urinary factors. They are not an acute complication of closed fractures in the immediate post-injury period and are not a primary concern during the first 24 hours.
D. Volkmann ischemic contracture: Volkmann contracture is a late complication of untreated compartment syndrome, typically developing days to weeks after the initial ischemic event. Monitoring for early signs of compartment syndrome is critical to prevent this long-term deformity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Feels alienated from their friends: Preschoolers typically do not have a fully developed understanding of illness or death, so feelings of alienation from friends are not an expected developmental response. Their social awareness is limited, and they are more focused on immediate experiences than abstract concepts like mortality.
B. Understands that death is inevitable: Preschoolers generally lack the cognitive development to grasp the permanence of death. They often view death as reversible or temporary, so expecting them to understand its inevitability does not align with typical developmental stages.
C. Believes that death is temporary: At the preschool age, children often see death as a temporary state, similar to sleeping or going away. This belief is consistent with their developmental stage and limited understanding of abstract concepts such as life and mortality.
D. Expresses anxiety about physical changes: While some preschoolers may notice physical changes related to illness, their understanding of these changes is limited, and they are unlikely to articulate anxiety about bodily transformations in the context of terminal illness. Their concerns are more concrete and immediate.
Correct Answer is ["B","D"]
Explanation
Rationale for correct choices
• Mucous membranes pink and moist: Indicates adequate hydration and perfusion status. The improvement from the prior day’s assessment reflects positive fluid balance and appropriate nursing management.
• SpO2 98% on room air: Reflects adequate oxygenation without supplemental oxygen, demonstrating respiratory stability and effective tissue oxygen delivery.
Rationale for findings not indicating expected progress
• Nuchal rigidity present: Persistence of nuchal rigidity indicates ongoing meningeal irritation and does not reflect improvement. This finding requires continued monitoring and management to prevent complications.
• Temperature 38.9° C (102° F): The child remains febrile, indicating that infection is still present. Although other vital signs are improving, the fever demonstrates that full clinical resolution has not yet occurred.
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