A nurse is teaching a client who was recently diagnosed with type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

Rationale:

A. Obtaining the initial assessment of assigned clients: Initial assessments require nursing judgment and are part of the nursing process, which cannot be delegated to assistive personnel. Only licensed nurses may perform comprehensive initial assessments.

B. Changing a nonsterile dressing: This is a routine and predictable task that does not require clinical judgment and can be safely delegated to assistive personnel, depending on facility policy and the client’s condition.

C. Interpreting a client's diagnostic laboratory results: Interpretation of lab values requires analysis and clinical decision-making, which are nursing responsibilities. Assistive personnel are not licensed to interpret or evaluate clinical data.

D. Educating a client and family members on home care: Client education involves assessing understanding, using clinical knowledge, and adapting teaching methods, functions reserved for licensed nurses, not assistive personnel.

Rationale for Correct Choices:

• Pain medication: Pain control is a primary concern in fracture management, especially in pediatric clients. This child reports a pain score of 4/10, indicating discomfort. Administering pain medication will reduce suffering and help prevent complications such as anxiety or guarding, which may impair healing.
• Limb immobilization: Immobilization stabilizes the fracture site and prevents further injury to soft tissues or neurovascular structures. With a nondisplaced fracture of both radius and ulna, the nurse should expect a splint or cast order to limit movement and aid in bone alignment and healing.

Rationale for Incorrect Choices:

• Bed rest: Bed rest is not required for isolated upper limb fractures, particularly when the child is developmentally appropriate, alert, and ambulatory. Encouraging mobility is important to reduce the risk of complications like deconditioning or thromboembolism.
• Surgical consultation: A nondisplaced fracture typically does not require surgical intervention unless complications develop. Surgical consultation is more often necessary for open, displaced, or unstable fractures that require reduction or fixation.
• Antibiotics: There are no signs of systemic or localized infection. The child has a superficial knee abrasion but no open fracture or wound that would necessitate prophylactic antibiotics. Therefore, antibiotic use is not indicated in this situation.