A nurse is caring for a client who has a closed wound drainage system. Which of the following interventions should the nurse include in the plan care?

Rationale for Correct Choices

• Pain medication: Fractures cause pain due to bone and soft tissue injury. Administering analgesics helps manage discomfort, improves cooperation with care, and facilitates movement and participation in activities as tolerated. Pain control also reduces stress responses that can interfere with healing.

• Limb immobilization: Nondisplaced midshaft fractures of the radius and ulna require immobilization using a cast or splint to maintain proper alignment, prevent further injury, and promote bone healing. Immobilization also supports neurovascular protection and decreases the risk of displacement.

Rationale for Incorrect Choices

• Skin traction: Skin traction is typically used for femur or lower limb fractures, not isolated forearm fractures, and is unnecessary for nondisplaced radius and ulna fractures.

• Antibiotics: The fracture is closed and nondisplaced, with no open wound or infection, so prophylactic antibiotics are not indicated.

• Surgical consultation: Surgery is usually reserved for displaced, unstable, or complex fractures. This nondisplaced fracture can be managed conservatively with immobilization.

• Bed rest: While rest is important, strict bed rest is unnecessary for upper extremity fractures. The child can perform limited activities while the arm is immobilized.

Rationale:
A. Remove the restraints from the client: Restraints should be discontinued as soon as the client no longer poses a danger to themselves or others. Prompt removal prevents unnecessary restriction and respects the client’s rights and dignity.

B. Offer the client PRN pain medication: While assessing for discomfort is important, pain medication is not the immediate priority once the client is calm and cooperative, unless the client requests it or shows signs of pain.

C. Continue to monitor the client every 15 min: Monitoring should continue after restraint removal according to facility policy, but the first action is to remove the restraints to avoid unnecessary confinement.

D. Encourage the client to attend a group therapy session: While therapeutic activities are important, this is not the immediate action following restraint use. Ensuring the client’s safety and removing restraints takes priority.