The nurse is caring for an 84-year-old female client who was brought to the emergency room by her daughter, who related that her mother has had very recent mental status changes and periods of incontinence. What condition should the nurse first suspect?

A. Venous thromboembolism (VTE) - While VTE can cause leg pain and swelling, the presence of fever, chills, and localized trauma history in this scenario points more toward cellulitis.

B. Cellulitis
The client's symptoms, including pain, swelling, fever, chills, and sweating, are indicative of cellulitis, which is a bacterial skin infection. The history of trauma to the leg (hitting the leg on the car door) could have introduced bacteria into the skin, leading to the infection. The client's diabetes mellitus type 2 also increases the risk of developing skin infections due to impaired immune function and circulation. Cellulitis often presents with localized pain, swelling, warmth, redness, and systemic symptoms like fever and chills. Immediate medical evaluation and appropriate antibiotic treatment are necessary for cellulitis.

C. Arterial insufficiency - Arterial insufficiency typically presents with symptoms like intermittent claudication, rest pain, and non-healing wounds due to poor circulation. The symptoms described in the scenario are more consistent with an acute infection (cellulitis) rather than chronic arterial insufficiency.

D. Thrombocytopenia - Thrombocytopenia is a condition characterized by low platelet count and does not directly cause localized pain, swelling, and redness in the leg as described in the scenario.

A. The longer the joint is displaced, the more difficult it is to get it back in place:
This statement is correct. Prompt reduction of a dislocated joint is important because the longer the joint remains out of place, the more difficult it becomes to realign it. Delayed reduction can lead to complications and makes the process more challenging for healthcare providers.

B. Avascular necrosis may develop at the site if it is not promptly resolved:
Avascular necrosis is a condition where bone tissue dies due to a lack of blood supply. While it is a potential complication of hip dislocation, it is not the immediate rationale for considering hip dislocation a medical emergency. The urgency primarily lies in the difficulty of reducing the dislocation and preventing further complications.

C. The client's pain will increase until the joint is realigned:
This statement is partially correct. While it is true that dislocated joints are extremely painful, the urgency in reducing the dislocation is not solely based on pain management. It is essential to prevent complications, restore joint function, and minimize long-term damage to the affected area.

D. Dislocation can become permanent if the process of bone remodeling begins:
This statement is accurate. If a dislocated joint is not promptly reduced, the surrounding tissues may undergo changes, and the process of bone remodeling can begin. This can lead to the dislocation becoming more difficult or even impossible to reduce, resulting in a permanent dislocation. Early intervention is essential to prevent this outcome.