A nurse is caring for a client with a closed fracture.
Which clinical presentation should the nurse expect in this client?
A “I can feel a crunching sensation when I touch the area.”
B “My skin around the fracture is warm and red.”
C “I can’t move my limb due to the pain.”
D “The bone is sticking out of my skin.”
The Correct Answer and Explanation is:
The correct answer is C: “I can’t move my limb due to the pain.”
Explanation:
A closed fracture, also known as a simple fracture, refers to a break in a bone where the skin remains intact and there is no external wound. It differs from an open (or compound) fracture where the bone pierces through the skin, creating an open wound.
When a client presents with a closed fracture, common symptoms include:
- Pain and inability to move the limb: A hallmark feature of fractures is pain, especially when trying to move the affected limb. The pain is typically sharp and worsens with movement. The inability to move the limb due to pain, as indicated in option C, is a classic symptom associated with fractures. This occurs because the broken bone interrupts the function of muscles and joints, causing intense pain when movement is attempted.
- Swelling and bruising: Over time, the area around the fracture may become swollen and discolored due to bleeding from the injured bone or surrounding tissues.
- Deformity or misalignment: In some cases, the limb may appear deformed or misaligned if the bone has been displaced.
Other Options:
- A: “I can feel a crunching sensation when I touch the area”: This refers to crepitus, a grating sound or feeling caused by the rubbing of broken bone ends. While this can occur in some fractures, it’s not a primary indicator for a closed fracture specifically.
- B: “My skin around the fracture is warm and red”: Warmth and redness can suggest an inflammatory response, which is common after an injury. However, these symptoms are more indicative of an infection or a significant inflammatory condition rather than a hallmark sign of a closed fracture.
- D: “The bone is sticking out of my skin”: This describes an open or compound fracture, where the bone protrudes through the skin, creating a significant risk for infection. Since this client has a closed fracture, this option is incorrect.
In summary, with a closed fracture, the client is likely to experience severe pain and restricted movement due to the break. Proper immobilization, pain management, and medical intervention are essential to promote healing and prevent complications.