A child sustains a supracondylar fracture of the femur. When assessing for vascular injury, the nurse should be alert for the signs of ischemia, which include:

Question

Options

• ABleeding, bruising, and hemorrhage
• BIncrease in serum levels of creatinine, alkaline phosphatase, and aspartate transaminase
• CPain, pallor, pulselessness, paresthesia, and paralysis
• DGeneralized swelling, pain, and diminished functional use with muscle rigidity and crepitus

• B
  4% (1)
• C
  91% (21)
• D
  4% (1)

Explanation

(A) Bleeding, bruising, and hemorrhage may occur due to injury but are not classic signs of (B) An increase in serum levels of creatinine, alkaline phosphatase, and aspartate transaminase is related to the disruption of muscle integrity. (C) Classic signs of ischemia related to vascular injury secondary to long bone fractures include the five "P's": pain, pallor, pulselessness, paresthesia, and paralysis. (D) Generalized swelling, pain, and diminished functional use with muscle rigidity and crepitus are common clinical manifestations of a fracture but not ischemia.

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