A client with a right ulnar fracture and cast placement reports an increase in arm pain. Which action should the nurse take next?

C. Elevating the head of the bed to 90 degrees (semi-Fowler's position) can help improve respiratory mechanics and lung expansion, making breathing easier for the client. This position can also help reduce the risk of aspiration and improve oxygenation in clients with respiratory distress.
A. Identifying and addressing triggers that exacerbate asthma symptoms is crucial for managing asthma effectively. By determining the client's exposure to triggers such as allergens, pollutants, or irritants, the nurse can help prevent future asthma exacerbations and tailor the client's management plan accordingly. However, this is done after the client is stabilized.
B. While teaching proper inhaler technique is an essential aspect of asthma management, the priority in this scenario is addressing the client's immediate respiratory distress. The client is already receiving a steroid nebulizer treatment, which is aimed at providing rapid relief and improving lung function. Teaching proper inhaler technique can be addressed later once the client's respiratory distress is stabilized.
D. While monitoring pulse oximetry is essential for assessing oxygenation and respiratory status, the frequency of monitoring may need to be increased in a client with asthma in respiratory distress. Clients experiencing respiratory distress may have rapid changes in oxygen saturation levels, necessitating more frequent monitoring to ensure timely intervention if oxygenation deteriorates.

Positive health promotion activities include inquiring about blood pressure, asking questions about self-care, executing pull-ups on a trapeze bar, and turning side to side.

Negative health promotion activities include requesting the nurse to perform wound care and avoiding looking at the residual limb.

Rationale

POSITIVE:

Inquires about blood pressure:

Inquiring about blood pressure shows awareness of cardiovascular health, which is important for individuals with peripheral vascular disease. Monitoring blood pressure regularly can help prevent complications and manage hypertension, a common comorbidity in peripheral vascular disease.

Asks questions about self-care:

Asking questions about self-care indicates engagement in the management of one's health post- amputation. Understanding self-care tasks, such as wound care, prosthetic use, and rehabilitation exercises, is crucial for optimal recovery and adjustment to life after amputation. Executes pull-ups on trapeze bar:

Engaging in physical activity, such as pull-ups on a trapeze bar, demonstrates motivation for rehabilitation and adaptation to life after amputation. Strengthening exercises can improve overall physical function and assist in adjusting to mobility with a prosthetic limb.

Turns side to side:

Turning side to side suggests mobility and activity post-amputation. Movement and repositioning are important for preventing complications such as pressure ulcers and promoting circulation in individuals with peripheral vascular disease.

NEGATIVE

Requests nurse to perform wound care:

Negative: While it's understandable for a client to initially require assistance with wound care post-amputation, relying solely on the nurse to perform wound care may indicate a lack of engagement in self-management and may hinder the client's transition to independence in managing their health post-amputation.

Avoids looking at residual limb:

Negative: Avoiding looking at the residual limb may indicate psychological distress or difficulty accepting the amputation. It's important for individuals post-amputation to gradually become comfortable with their changed body image and to address any psychological challenges through counseling or support groups.