A nurse is assessing a child who has multiple closed fractures of the lower extremities due to a motor-vehicle crash. The nurse should monitor the child for which of the following complications during the first 24 hr after the injury occurred?

This case involves monitoring for immediate postoperative or post-trauma complications following long bone fractures. Applying knowledge of vascular and nerve compression from swelling or inflammation within muscular fascia is essential to identify the highest risk during the first day. Choice A rationale . Volkmann ischemic contracture is a late complication resulting from untreated compartment syndrome. It involves permanent shortening of forearm muscles. While serious, it does not typically manifest as the primary acute concern within the initial 24-hour window. Choice B rationale . Renal calculi result from prolonged immobility and hypercalcemia due to bone decalcification. This complication develops over weeks or months of bed rest. It is not an acute concern in the first 24 hours following a traumatic injury. Choice C rationale . Compartment syndrome is a life-threatening acute complication where increased pressure within muscle fascia compromises circulation. This typically occurs within the first 24 hours post-fracture due to edema or hemorrhage, requiring immediate surgical intervention to prevent necrosis. Choice D rationale . Osteomyelitis is an infection of the bone that generally presents several days to weeks after an injury or surgery. Although it is a potential complication of fractures, it does not typically manifest during the initial 24-hour period.