Which finding would the nurse assessing the neurovascular status of a child in Russell traction report immediately?

Choice A reason: Obtaining IV access is critical for seizure precautions, allowing rapid administration of antiepileptic drugs (e.g., lorazepam) in case of prolonged seizures. IV access ensures prompt treatment to prevent status epilepticus, which can cause neuronal damage or hypoxia.
Choice B reason: Keeping lights on during sleep is not a seizure precaution. It may disrupt sleep, increasing seizure risk by lowering the seizure threshold due to fatigue, and does not directly contribute to safety during a seizure event.
Choice C reason: Placing the bed in a high position increases the risk of falls during a seizure, as uncontrolled movements may cause the client to fall from a greater height, leading to injury. A low bed is safer.
Choice D reason: Keeping a padded tongue blade is outdated and unsafe, as inserting objects during a seizure risks dental injury or airway obstruction. Current guidelines prioritize airway protection and environmental safety, not tongue blades.

Choice A reason: Stress fractures result from repetitive microtrauma, common in athletes, not typically associated with abuse. In children, they occur from overuse (e.g., sports), not acute trauma, making them less suspicious for non-accidental injury compared to other fracture types.
Choice B reason: Compound fractures, where bone pierces the skin, result from high-impact trauma (e.g., falls). While possible in abuse, they are less specific, as they occur in accidents, making them less indicative of non-accidental injury than spiral fractures.
Choice C reason: Spiral fractures occur from twisting forces, often seen in abuse when a limb is forcefully twisted (e.g., by an adult). In children, whose bones are flexible, spiral fractures suggest significant force, raising suspicion of non-accidental trauma.
Choice D reason: Greenstick fractures, where the bone bends and partially breaks, are common in children due to pliable bones. They occur in accidents or minor trauma, making them less specific to abuse compared to spiral fractures’ association with twisting mechanisms.