The nurse is performing an assessment on a client admitted with a fractured left humerus. When the client moves the extremity, the nurse notes the presence of a grating sound. Which is the nurse's best intervention?
a. Immobilize the arm.
b. Perform range of motion.
c. Monitor for other signs of infection.
d. Administer steroids.
A
The grating sound heard when the affected part is moved is known as crepitation. This sound is created by bone fragments. Because bone fragments may be present, the nurse should immobilize the client's arm and tell him or her not to move the arm. The nurse should not move the extremity for range of motion. The grating sound does not indicate infection. Steroids would not be indicated.
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