A school nurse is observing a child with ADHD who frequently leaves their seat, talks excessively, and interrupts peers.
What is the most appropriate intervention?

Choice A rationale

Performing a fasciotomy is a surgical procedure, not an initial nursing intervention. While it may be necessary to relieve compartment syndrome, it is outside the scope of nursing practice and is typically performed by a physician. The nurse's role is to identify the signs and symptoms and escalate to the medical team for this definitive treatment.

Choice B rationale

Loosening the cast dressings or bandages directly addresses the potential cause of compartment syndrome by reducing external compression. This action aims to improve blood flow and nerve function by alleviating pressure on the neurovascular structures within the confined space. This can prevent further tissue ischemia and damage.

Choice C rationale

Elevating the affected limb above heart level can paradoxically worsen compartment syndrome. Elevation decreases arterial perfusion pressure, further compromising blood flow to the already ischemic tissues within the rigid fascial compartment. This can exacerbate tissue hypoxia and cellular damage, increasing the risk of irreversible injury.

Choice D rationale

Applying ice to the affected area causes vasoconstriction, which would further reduce blood flow to the compromised tissues within the compartment. This decrease in perfusion would exacerbate ischemia and hypoxia, potentially worsening tissue damage and accelerating the progression of compartment syndrome. Therefore, ice application is contraindicated.

Choice A rationale

A 10-degree scoliosis curvature is considered a very mild curve and often falls within the normal range or represents postural asymmetry. At this degree, bracing is not typically recommended; instead, observation and regular monitoring are usually sufficient to track progression, as spontaneous resolution is possible.

Choice B rationale

A 48-degree scoliosis curvature is a significant and severe curve that typically indicates advanced scoliosis. At this degree, bracing alone is often insufficient to correct the curve, and surgical intervention, such as spinal fusion, is usually recommended to prevent further progression and mitigate severe complications.

Choice C rationale

A 30-degree scoliosis curvature in adolescents is a threshold where a brace is typically recommended. This degree of curvature indicates a progressive curve that is likely to worsen if left untreated. Bracing aims to halt the progression of the curve during the adolescent growth spurt, preventing the need for surgery.

Choice D rationale

A 20-degree scoliosis curvature is a moderate curve. While it is more significant than a 10-degree curve, it is often still managed with close observation and monitoring, especially if the adolescent has significant growth remaining. Bracing might be considered, but 30 degrees is a more common guideline for initiation.