A 3-year-old child is brought to the clinic by a parent who reports that the child refuses to use the right arm after being swung by both arms while playing. The child is sitting with the right arm held slightly flexed and close to the body. There is no swelling or ecchymosis present. What will the primary care pediatric nurse practitioner do?

Question

Quizplus · Accepted Answer

Based on the history provided, it is possible that the child may have sustained a nursemaid's elbow (radial head subluxation). This can occur when a child's arm is pulled or jerked suddenly. The primary care pediatric nurse practitioner can gently attempt a supination and flexion technique to relocate the radial head. A radiograph may be obtained if there is suspicion for a fracture or if the maneuver is unsuccessful. Maltreatment should not be assumed without further investigation or evidence. Immobilization with a sling may not be necessary if the radial head is relocated successfully. Referral to orthopedics may be indicated if there is suspicion for a more severe injury or if the maneuver is unsuccessful.

A 3-Year-Old Child Is Brought to the Clinic by a Parent