A 7-year-old child has just had a cast applied for a fractured ...

[maegan_martin]

A 7-year-old child has just had a cast applied for a fractured arm with the wrist and elbow immobilized. What information should be included in the home care instructions?
 
  a. No restrictions of activity are indicated.
  b. Elevate casted arm when both upright and resting.
  c. The shoulder should be kept as immobile as possible to avoid pain.
  d. Swelling of the fingers is to be expected. Notify a health professional if it persists more than 48 hours.

Question 2

Parents bring a 7-year-old child to the clinic for evaluation of an injured wrist after a bicycle accident. The parents and child are upset, and the child will not allow an examination of the injured arm.
 
  What priority nursing intervention should occur at this time?
  a. Send the child to radiology so radiography can be performed.
  b. Initiate an intravenous line and administer morphine for the pain.
  c. Calmly ask the child to point to where the pain is worst and to wiggle fingers.
  d. Have the parents hold the child so that the nurse can examine the arm thoroughly.

[cam1229]

Answer to Question 1

ANS: B
The injured extremity should be kept elevated while resting and in a sling when upright. This will increase venous return. The child should not engage in strenuous activity for the first few days. Rest with elevation of the extremity is encouraged. Joints above and below the cast on the affected extremity should be moved. Swelling of the fingers may indicate neurovascular damage and should be reported immediately. Permanent damage can occur within 6 to 8 hours.

Answer to Question 2

ANS: C
Initially, assessment is the priority. Because the child is alert but upset, the nurse should work to gain the child's trust. Initial data are gained by observing the child's ability to move the fingers and to point to the pain. Other important observations at this time are pallor and paresthesia. The child needs to be sent for radiography, but initial assessment data need to be obtained. Sending the child for radiography will increase the child's anxiety, making the examination difficult. It is inappropriate to ask parents to restrain their child. These parents are upset about the injury. If restraint is indicated, the nurse should obtain assistance from other personnel.

[maegan_martin]

Correct answers!

[cam1229]

Great! Please up vote