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. Check the wound sites for manifestations of infection: Monitoring for infection is important in burn care, but immediate life-threatening complications include fluid and heat loss. Infection usually develops later, making it a serious but not the greatest immediate risk during dressing changes.
B. Perform passive range-of-motion exercises during the dressing change: Passive range-of-motion helps prevent contractures and maintain mobility, which is important for long-term recovery, but it does not address the most urgent risk to the client during burn care.
C. Adjust the room temperature to 33° C (91.4° F): Children and adolescents with multiple burns are at high risk for hypothermia due to impaired thermoregulation and extensive loss of skin. Maintaining a warm environment is crucial during dressing changes to prevent dangerous drops in core body temperature.
D. Apply tepid water to the old dressings before removal: Moistening the dressings helps reduce pain and prevent further tissue trauma, but it does not directly address the greatest immediate physiological risk, which is hypothermia in burn patients.
Correct Answer is B
Explanation
A. "Notify the provider if your child has dark brown blood between their teeth.": Dark brown or old blood is generally not a sign of active bleeding after a tonsillectomy. Concern should focus on bright red blood, which may indicate postoperative hemorrhage requiring prompt medical attention.
B. "Notify the provider if your child is swallowing frequently.": Frequent swallowing can be an early sign of active bleeding in the throat after a tonsillectomy. Parents should be instructed to monitor for this symptom and notify the provider immediately, as it may indicate postoperative hemorrhage.
C. "Encourage your child to clear their throat as needed.": Clearing the throat can disrupt the surgical site and increase the risk of bleeding. Children should be advised to avoid throat clearing and coughing to allow proper healing.
D. "Encourage your child to drink liquids through a straw.": Using a straw can create suction that may dislodge the surgical site and lead to bleeding. Children should be encouraged to sip liquids gently without a straw to prevent trauma to the tonsillar area.
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