A nurse is caring for a client who just had a left long-arm plaster cast applied after experiencing a musculoskeletal trauma. Which of the following actions should the nurse take?

Position the cast on a plastic-covered pillow.

Perform neurovascular checks every 2 hr.

Instruct the client to avoid moving the fingers on the left hand.

Touch the cast with the palms of the hands when moving the client.

Answer and Explanation

The Correct Answer is B

A) Position the cast on a plastic-covered pillow:
Positioning the cast on a plastic-covered pillow is not recommended because the plastic can trap moisture and heat, potentially affecting the cast's integrity as it dries. Instead, a soft, absorbent material should be used to support the cast.

B) Perform neurovascular checks every 2 hr:
Frequent neurovascular checks are essential to monitor for complications such as compartment syndrome, nerve damage, or impaired circulation. This action helps ensure that any changes in sensation, movement, or circulation are identified and addressed promptly.

C) Instruct the client to avoid moving the fingers on the left hand:
Encouraging the client to move their fingers is important to prevent stiffness and swelling and to promote circulation. Instructing the client to avoid moving their fingers is not appropriate and could lead to complications.

D) Touch the cast with the palms of the hands when moving the client:
Handling a wet plaster cast with the palms of the hands is correct to prevent indentations and pressure points that could cause skin irritation or pressure sores. However, this action is not as critical as performing frequent neurovascular checks to ensure the client's safety and monitor for complications.

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Correct Answer is D

Explanation

A) Decreased magnesium level: Primary aldosteronism typically affects sodium and potassium balance, but it is less likely to cause significant changes in magnesium levels. Therefore, a decreased magnesium level is not the expected electrolyte imbalance in this condition.

B) Decreased total calcium level: Primary aldosteronism does not primarily affect calcium metabolism. While calcium levels could be influenced indirectly, they are not a primary concern in this disorder. Hence, a decreased total calcium level is not expected.

C) Elevated phosphate level: Phosphate levels are generally not directly influenced by aldosterone. Elevated phosphate levels might be seen in other conditions, but they are not characteristic of primary aldosteronism.

D) Elevated sodium level: Primary aldosteronism leads to excess production of aldosterone, which promotes sodium retention by the kidneys. This retention causes elevated sodium levels, resulting in hypernatremia, and contributes to symptoms like frequent urination due to the body's attempt to excrete excess sodium through increased urine production.

A. "Limit sodium intake to 3,500 milligrams per day." B. "Take ibuprofen for discomfort." C. "Increase the distance you walk by 100 feet daily, even if you feel fatigued." D. "Include no more than 2,000 milliliters of fluid intake in 24 hours."

Correct Answer is D

Explanation

A) "Limit sodium intake to 3,500 milligrams per day.":
Limiting sodium intake is crucial for managing heart failure to prevent fluid retention and exacerbation of symptoms. However, the recommended limit is typically much lower, around 1,500 to 2,000 milligrams per day, not 3,500 milligrams.

B) "Take ibuprofen for discomfort.":
Ibuprofen and other NSAIDs are not recommended for clients with heart failure as they can cause fluid retention, worsen heart failure symptoms, and increase the risk of kidney problems. Alternatives such as acetaminophen are generally safer for pain relief.

C) "Increase the distance you walk by 100 feet daily, even if you feel fatigued.":
While regular exercise is important, clients with heart failure should not push through fatigue, as overexertion can lead to worsening symptoms. Exercise recommendations should be tailored to the individual's tolerance and should be adjusted based on their energy levels.

D) "Include no more than 2,000 milliliters of fluid intake in 24 hours.":
Restricting fluid intake to 2,000 milliliters per day helps prevent fluid overload, which is critical for managing heart failure. Monitoring and limiting fluid intake can help control symptoms such as edema and shortness of breath.

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A nurse is caring for a client who just had a left long-arm plaster cast applied after experiencing a musculoskeletal trauma. Which of the following actions should the nurse take?

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Explanation

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