The nurse provides counseling to a family of a patient with Duchenne muscular dystrophy with the knowledge that

Choice A reason: An open fracture involves bone piercing the skin, exposing it to the environment, often from high-impact trauma. Osteoporosis causes weakened bones, but a spontaneous hip fracture typically occurs without external trauma or skin breach. This term does not apply, as the fracture results from underlying bone pathology, not an open wound.

Choice B reason: A pathologic fracture occurs in diseased bone, such as in osteoporosis, where reduced bone density causes fragility. A spontaneous hip fracture in this context results from minimal or no trauma, reflecting the weakened bone structure. This documentation accurately describes the fracture’s etiology, linking it to the underlying condition of osteoporosis.

Choice C reason: An oblique fracture describes a diagonal break across the bone, typically from twisting forces. While possible in osteoporosis, the term does not address the spontaneous nature or underlying bone weakness. Pathologic fracture is more specific, as it indicates the fracture’s cause, not just its physical pattern.

Choice D reason: A greenstick fracture is an incomplete break, common in children due to flexible bones, where the bone bends and partially fractures. Osteoporotic hip fractures in adults are typically complete due to brittle bones. This term is inappropriate, as it does not reflect the pathology or spontaneous nature of the injury.

Choice A reason: Applying ice reduces swelling and pain in a possible fracture, which is beneficial but not the first priority. Ice application does not assess the limb’s viability or detect complications like vascular injury or nerve damage. A neurovascular check is critical to ensure circulation and nerve function before interventions like ice, which could mask symptoms.

Choice B reason: Elevating the arm minimizes swelling by promoting venous return, aiding in pain relief and reducing pressure. However, it is secondary to a neurovascular check, which assesses circulation, sensation, and movement. Elevation without confirming vascular integrity risks missing critical injuries like arterial compression, which could lead to ischemia if untreated.

Choice C reason: Notifying the health care provider is necessary for diagnostic imaging and treatment planning but is not the first action. A neurovascular check provides immediate data on limb status, guiding urgency of notification. Delaying assessment risks missing acute complications like compartment syndrome, which requires prompt intervention to prevent permanent damage.

Choice D reason: Performing a neurovascular check first assesses distal pulses, sensation, movement, and capillary refill, detecting complications like vascular occlusion or nerve injury from a possible fracture. Fractures can compress arteries or nerves, risking ischemia or neuropathy. Early identification ensures timely intervention, making this the priority before splinting or other actions to preserve limb function.