Post-operative SCFE patient with fever on day 3 and a wound that is draining: the nurse's priority concern is:

• A. Wound infection
• B. Growth deficit on that leg
• C. Osteomyelitis
• D. The other leg being impaired

Answer: (C)

The key idea is recognizing that fever with a draining wound after orthopedic surgery in a child signals a potential bone infection. In this scenario, osteomyelitis is the highest-priority concern because infection of the bone near the growth plate in the proximal femur can progress rapidly and lead to sepsis or long-term growth problems if not treated promptly. This requires prompt evaluation, obtaining cultures, and initiating broad-spectrum IV antibiotics after cultures, with imaging to confirm bone infection and close involvement of the surgical team. While a wound infection is serious, bone infection poses the greater immediate risk; growth deficit on that leg is a potential consequence but not the urgent threat, and issues with the other leg are not related to the current crisis.