A nurse is caring for a client following application of a cast. Which of the following actions should the nurse take first?

Place an ice pack over the cast.

Position the casted extremity on a pillow.

Teach the client to keep the cast clean and dry.

Palpate the pulse distal to the cast.

Answer and Explanation

The Correct Answer is D

A. Place an ice pack over the cast. While this can help reduce swelling and pain, it is a comfort measure, not the priority. Safety assessments must be completed first before implementing non-urgent interventions.
B. Position the casted extremity on a pillow. Elevation is important to reduce swelling, but it follows after ensuring that circulation to the extremity is intact and that there are no signs of vascular compromise.
C. Teach the client to keep the cast clean and dry. Education is essential for long-term cast care, but it is not the first action after cast application. Immediate post-procedural monitoring takes precedence.
D. Palpate the pulse distal to the cast. The nurse should first assess for adequate circulation by checking distal pulses. This helps identify early signs of complications like compartment syndrome or impaired blood flow, making it the highest priority.

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Correct Answer is C

Explanation

A. Decrease the maintenance infusion rate of IV fluid. Epidural anesthesia can cause hypotension, so IV fluids are often used to help maintain blood pressure. Reducing the fluid rate may increase the risk of hypotensive episodes.
B. Have protamine sulfate available at the bedside. Protamine sulfate is the antidote for heparin, not relevant to epidural anesthesia. It is not required in the management of epidural-related side effects.
C. Reposition the client side-to-side each hour. Frequent repositioning helps prevent pressure injuries, promotes fetal oxygenation, and encourages effective labor progression. It also aids in the distribution of the anesthetic agent.
D. Monitor the client for hypertension. Hypotension, not hypertension, is a common adverse effect of epidural anesthesia due to vasodilation and decreased peripheral resistance. Blood pressure should be monitored closely for drops.

A. "I will use a communication board to assess the client's needs." B. “I will collaborate with a speech therapist about the client's plan of care." C. "I will use indirect lighting in the client's room." D. “I will use a loud tone of voice when speaking with the client.”

Correct Answer is C

Explanation

A. Using a communication board is appropriate for clients with speech or language impairments, not visual impairment.
B. Collaborating with a speech therapist is indicated for speech or communication disorders, not vision loss.
C. Using indirect lighting in the room is correct because it reduces glare and enhances visibility for clients with visual impairment, improving safety and comfort.
D. Speaking in a loud tone of voice is unnecessary unless the client also has a hearing impairment; visual impairment does not affect hearing.

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A nurse is caring for a client following application of a cast. Which of the following actions should the nurse take first?

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