The nurse receives report on 4 clients. Which client should be seen first?

Question

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This client is exhibiting localized (eg, pain, limited range of motion) and systemic infection symptoms (eg, fever), which may indicate septic arthritis. Possible causes include recent surgery, injections, trauma, or spread from adjacent infection (eg, cellulitis). A septic hip is considered a surgical emergency. The hip joint is prone to develop avascular necrosis (eg, damage to the femoral head) from compromised blood supply due to infection or injury (eg, fracture). This can result in sequelae that are significant in both the short term (eg, sepsis, death) and long term (eg, joint destruction). Management includes culturing synovial fluid and blood, giving antibiotics, and debriding the infected joint. (Option A) Bronchitis is linked to viral upper respiratory infections and is common during childhood. Congestion and a productive cough are anticipated. This client is currently able to maintain an airway and manage secretions and therefore is not the priority. (Option B) This client with epistaxis should be instructed to sit slightly forward while pinching the nose. The client should be reevaluated in 10-20 minutes for resolution of bleeding. (Option C) Urinary tract infections may present with urinary frequency, burning with urination, and fever. This is not a priority over potential septic arthritis. Educational objective: Pain, limited range of motion, and fever indicate joint infection (septic joint). A septic hip is a surgical emergency as impaired blood supply may lead to permanent joint destruction, sepsis, and/or death. The nurse should expect management to include cultures, antibiotics, and surgical debridement.

The Nurse Receives Report on 4 Clients