The emergency room nurse is caring for a family who lost an adolescent in a violent car accident. Which initial nursing action best helps the family’s grieving process?

Choice A reason: Rheumatic fever follows streptococcal infections but typically presents with joint pain or carditis, not puffy eyes or abnormal urine. Glomerulonephritis matches the post-infectious symptoms, making this incorrect, as it does not align with the child’s clinical presentation after ear infections.

Choice B reason: Lipoid nephrosis causes edema but lacks a clear link to recent infections or hematuria. Acute glomerulonephritis better explains the symptoms post-ear infection, making this less fitting and incorrect for the suspected condition based on the child’s reported signs and history.

Choice C reason: Urinary tract infections cause dysuria or frequency, not typically puffy eyes or hematuria post-infection. Glomerulonephritis aligns with the streptococcal history and symptoms, making this incorrect compared to the condition suspected based on the child’s clinical presentation to the nurse.

Choice D reason: Acute glomerulonephritis, often post-streptococcal from ear infections, causes hematuria (“funny” urine), periorbital edema (puffy eyes), and headache. This aligns with pediatric nephrology evidence, making it the correct condition the nurse suspects, prompting immediate evaluation by a care provider for the child.

Choice A reason: A complete fracture occurs when bone fragments are fully separated, disrupting the bone’s continuity. This aligns with orthopedic definitions, as separation indicates a break through the entire bone, requiring intervention. The nurse’s explanation matches this, making it the correct term for separated fracture fragments in children, consistent with pediatric trauma care.

Choice B reason: An incomplete fracture involves a partial break, with fragments not fully separated, common in children’s flexible bones. The question specifies separated fragments, which does not fit this definition. This choice is incorrect, as it contradicts the description of a complete separation of bone fragments in the context of fracture classification.

Choice C reason: A spiral fracture is caused by twisting, with a helical break pattern, but separation of fragments is not its defining feature. Complete fractures specifically describe separated fragments, making this incorrect, as spiral refers to shape, not the extent of fragment separation in fractures, per orthopedic terminology.

Choice D reason: A greenstick fracture is an incomplete break where one side bends and the other cracks, typical in children. Separated fragments indicate a complete fracture, not a greenstick, making this incorrect, as greenstick fractures do not involve full separation of bone fragments as described in the nurse’s explanation.