What is a physiologic effect of immobilization on children? a. ...

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What is a physiologic effect of immobilization on children?
 
  a. Metabolic rate increases.
  b. Venous return improves because the child is in the supine position.
  c. Circulatory stasis can lead to thrombus and embolus formation.
  d. Bone calcium increases, releasing excess calcium into the body (hypercalcemia).

Question 2

The nurse stops to assist an adolescent who has experienced severe trauma when hit by a motorcycle. The emergency medical system (EMS) has been activated. The first person who provided assistance applied a tourniquet to the child's leg
 
  because of arterial bleeding. What should the nurse do related to the tourniquet?
  a. Loosen the tourniquet.
  b. Leave the tourniquet in place.
  c. Remove the tourniquet and apply direct pressure if bleeding is still present.
  d. Remove the tourniquet every 5 minutes, leaving it off for 30 seconds each time.

[soda0602]

Answer to Question 1

ANS: C
The physiologic effects of immobilization, as a result of decreased muscle contraction, include venous stasis. This can lead to pulmonary emboli or thrombi. The metabolic rate decreases with immobilization. With the loss of muscle contraction, there is a decreased venous return to the heart. Calcium leaves the bone during immobilization, leading to bone demineralization and increasing the calcium ion concentration in the blood.

Answer to Question 2

ANS: B
A tourniquet is applied only as a last resort, and then it is left in place and not loosened until definitive treatment is available. After the tourniquet is applied, skin and tissue necrosis occur below the site. Loosening or removing the tourniquet allows toxins from the tissue necrosis to be released into the circulation. This can induce systemic, deadly tourniquet shock.