An elderly client with osteoporosis falls onto an out-stretched hand and injures the wrist. The client has severe wrist edema, deformity, and pain rated a 10 on a pain scale of 0-10. What should be the nurse's first action?

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11ecbb05_ca07_9d6d_b433_ddc71fb69c8b_MD0009_00 A Colles' fracture is a type of wrist fracture (distal radius fracture) that causes a characteristic dinner fork deformity of the wrist. It usually occurs when the client tries to break a fall with an outstretched arm or hand, and lands on the heel of the hand. It is one of the most common fractures in women age >50 and is related to osteopenia or osteoporosis. While the client is undergoing evaluation by the health care provider (HCP) in the emergency department (ED), nursing interventions should include: Performing a neurovascular assessment (eg, pulse, temperature, color, capillary refill, sensation, movement). This is the priority nursing action as neurovascular insufficiency related to swelling (eg, compartment syndrome) or arterial/nerve damage by the bone fragments is associated with a Colles' fracture. If neurovascular status is compromised, urgent reduction of the fracture is indicated. Administering analgesia to promote comfort (Option A). Applying an ice pack to the wrist to help reduce edema and inflammation (Option B). Elevating the extremity on a pillow above heart level to reduce edema (Option D). Instructing the client to move the fingers to reduce edema, increase venous return, and help improve range of motion. Educational objective: While a client with a traumatic wrist fracture is undergoing evaluation by the HCP in the ED to determine appropriate treatment, the nurse assesses circulation, sensation, and movement of the affected hand, and then performs nursing interventions to reduce pain and edema.

An Elderly Client with Osteoporosis Falls onto an Out-Stretched Hand