The nurse is caring for a child with osteomyelitis.
Which of the following interventions is a priority?

Choice A rationale

This describes an incomplete fracture, where the bone's continuity is not completely disrupted. The periosteum and some bone matrix remain intact, providing some structural continuity. This type of fracture often involves a "greenstick" injury in children, where one side of the bone fractures and the other side bends.

Choice B rationale

A complete fracture involves a full break through the bone, resulting in two or more distinct bone fragments that are no longer connected. This disruption compromises the structural integrity of the bone, leading to instability and potential displacement of the fragments.

Choice C rationale

This describes an open or compound fracture, where the fractured bone fragments penetrate the skin, creating an open wound. While often a complete fracture, the defining characteristic here is the skin penetration and increased risk of infection, not just the separation of fragments.

Choice D rationale

This describes a bend deformity or an incomplete fracture, often seen in children due to the greater flexibility of their bones compared to adults. The bone's plastic deformation allows it to bend without a complete break, preserving some structural continuity.

Choice A rationale

Continuous labor support, often provided by doulas or trained birth companions, significantly reduces perceived pain intensity. This is mediated by physiological mechanisms like decreased sympathetic nervous system activation, leading to lower circulating catecholamines, and increased release of endogenous opioids, which naturally mitigate pain signals by binding to mu-opioid receptors in the central nervous system.

Choice B rationale

The presence of a supportive individual during labor fosters a sense of security and control for the birthing person. This psychosocial benefit contributes to a more positive subjective experience, reducing feelings of isolation and fear. Emotional support can lead to increased coping efficacy and a greater sense of satisfaction with the birthing process.

Choice C rationale

Research indicates that continuous labor support is associated with better fetal outcomes, including a reduced incidence of fetal distress and fewer low Apgar scores. This may be attributed to decreased maternal stress hormone levels, which can negatively impact uterine blood flow and oxygen delivery to the fetus, thus promoting a more stable intrauterine environment.

Choice D rationale

Improved client outcomes encompass a range of positive effects, such as reduced rates of medical interventions like epidural anesthesia and cesarean sections. The presence of support often empowers the client to labor more effectively, leading to shorter labor durations and a decreased need for pharmacological pain management, contributing to overall maternal well-being.

Choice E rationale

Increased anxiety is an incorrect benefit. Scientific evidence consistently demonstrates that continuous support during labor actually reduces maternal anxiety and stress levels. The presence of a supportive individual provides emotional reassurance and practical assistance, which helps to alleviate fear and promote a sense of calm during the birthing process.