What is an essential nursing consideration for a patient with a suspected fracture before moving or handling the affected limb?
Explaining the importance of immobilization to the patient
Applying a splint or cast to the affected limb
Assessing for any signs of neurovascular compromise
Administering analgesics for pain relief
The Correct Answer is C
Before moving or handling the affected limb, the nurse must assess for any signs of neurovascular compromise, such as changes in pulses, capillary refill, sensation, and motor function. This assessment helps identify potential vascular or nerve injuries and guides appropriate care to prevent complications.
a. Explaining the importance of immobilization to the patient is important but is not directly related to assessing for neurovascular compromise before moving the limb.
b. Applying a splint or cast to the affected limb is typically done after the initial assessment and diagnosis of the fracture, not before handling the limb.
d. Administering analgesics for pain relief is important, but it does not directly relate to assessing for neurovascular compromise before moving the limb.
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Correct Answer is A
Explanation
X-ray is the most appropriate initial diagnostic study for suspected fractures. It provides clear images of bones and can help identify the presence, location, and extent of the fracture.
b. MRI: MRI is useful for soft tissue imaging, but it may not be the first choice for initial evaluation of fractures. X-rays are more commonly used for immediate assessment.
c. CT scan: CT scan can provide detailed images of bones and soft tissues, but it is not typically the first-line imaging study for fractures. X-rays are more commonly performed first.
d. Ultrasound: Ultrasound is primarily used for imaging soft tissues and may not provide sufficient detail for evaluating fractures. X-rays are more appropriate for initial assessment.
Correct Answer is D
Explanation
Severe pain, pallor (pale skin color), and loss of pulses distal to the fracture are concerning signs of compartment syndrome, a serious complication that requires immediate medical intervention.
a. Bruising and discoloration at the fracture site: Bruising and discoloration are common signs of inflammation and injury at the fracture site but are not specific to compartment syndrome.
b. Mild pain and swelling in the affected limb: Mild pain and swelling are expected with a fracture but do not raise immediate concerns for compartment syndrome.
c. Prolonged capillary refill distal to the fracture: Prolonged capillary refill time may indicate reduced blood flow but is not as concerning as the combination of severe pain, pallor, and loss of pulses seen in compartment syndrome.
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