The nurse is caring for a client who has just returned from external fixation device placement for stabilization of a fractured femur. Which of the following interventions are appropriate to include in the client's plan of care? Select all that apply.

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11ecbb05_ca15_ce4c_b433_7f5cc643617a_MD0009_00 An external fixator is a device used to stabilize broken bones; metal pins are placed through the tissue into the bone and connect to a frame outside the skin. The nurse should monitor clients with external fixation closely for signs of neurovascular compromise and pin site infection, which can lead to osteomyelitis. When caring for clients with external fixation, the nurse can help prevent infection and maintain extremity and device integrity by: Assessing the pin sites regularly for new, increased, and/or purulent drainage and checking the skin surrounding the pins for erythema, warmth, pain, or breakdown (Option A) Assessing for signs of compartment syndrome (eg, decreased pulses, coolness, pain, numbness) (Option D) Performing pin site care with a sterile cleaning solution (eg, chlorhexidine, sterile normal saline) and gauze (Option E) Monitoring pins and device for loosening and reporting to the health care provider (HCP) if they are loose (Option B) The nurse should never manipulate loose pins but should instead notify the HCP immediately if loose pins are noted on assessment. (Option C) The nurse should promote early mobilization for clients with external fixation devices. Some clients may begin walking with physical therapy the day after surgery. Educational objective: When caring for clients with external fixation, the nurse should assess for signs of infection (eg, pin site drainage), perform pin care with a sterile cleaning solution, assess for loose pins, monitor for signs of neurovascular impairment (eg, decreased pulses, coolness), and promote early mobilization.

The Nurse Is Caring for a Client Who Has Just