A nurse is providing discharge education to a client who is going home with a cast on his leg. What teaching point would be appropriate for the nurse to emphasize in the teaching session?
Report any pain that is uncontrolled by elevating the affected limb or by analgesic agents
May use intermittent heat packs as prescribed to control swelling
A small hair brush may be used to control any itching under the cast
Keep the affected extremity below the level of the heart to prevent swelling
Inspect the cast daily for cracks, breaks, or signs of infection
The Correct Answer is A
Choice A reason: Reporting any pain that is uncontrolled by elevating the affected limb or by analgesic agents is an appropriate teaching point for the nurse to emphasize, as it may indicate a serious complication such as compartment syndrome, infection, or nerve damage. The nurse should instruct the client to notify the health care provider immediately if the pain persists or worsens.
Choice B reason: Using intermittent heat packs as prescribed to control swelling is not an appropriate teaching point for the nurse to emphasize, as it may increase the blood flow and inflammation in the affected area. The nurse should advise the client to avoid heat sources such as heating pads, hot water bottles, or electric blankets, as they may also damage the cast or cause burns.
Choice C reason: Using a small hair brush to control any itching under the cast is not an appropriate teaching point for the nurse to emphasize, as it may cause skin irritation, infection, or damage to the cast. The nurse should suggest the client to use a cool air dryer, a gentle tapping, or an antihistamine to relieve the itching, and to avoid inserting any objects under the cast.
Choice D reason: Keeping the affected extremity below the level of the heart to prevent swelling is not an appropriate teaching point for the nurse to emphasize, as it may impair the venous return and increase the edema. The nurse should recommend the client to elevate the affected extremity above the level of the heart to reduce the swelling and promote the healing.
Choice E reason: Inspecting the cast daily for cracks, breaks, or signs of infection is not an appropriate teaching point for the nurse to emphasize, as it is not a specific or relevant instruction for the client with a cast on his leg. The nurse should teach the client to keep the cast dry and clean, to cover it with a plastic bag when showering or bathing, and to report any foul odor, drainage, or fever.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Rosacea is not a parasitic skin infestation, but a chronic inflammatory skin condition that causes redness, flushing, and bumps on the face.
Choice B reason: Pediculosis corporis is a parasitic skin infestation caused by body lice, but it is not the only one. The question asks for what the student should include in the presentation, not what is the most common or severe type of parasitic skin infestation.
Choice C reason: Sarcoptes scabiei is a parasitic skin infestation caused by scabies mites, which burrow into the skin and cause intense itching, rash, and secondary infections. This is a correct choice to include in the presentation, as scabies is a common and contagious condition that affects people of all ages and backgrounds.
Choice D reason: Furuncles are not a parasitic skin infestation, but a bacterial infection of the hair follicles that causes painful, pus-filled boils on the skin.
Choice E reason: Impetigo is not a parasitic skin infestation, but a bacterial infection of the skin that causes red, oozing, and crusted sores.
Correct Answer is C
Explanation
Choice A reason: Scabies can be cured with prescription medications that kill the mites and their eggs, such as permethrin cream or ivermectin pills. Steroid cream may help to reduce the itching and inflammation, but it does not eliminate the infection.
Choice B reason: Treatment should start as soon as possible after the diagnosis of scabies, but there is no specific time limit of 72 hours. The sooner the treatment begins, the faster the symptoms will improve and the risk of transmission will decrease.
Choice C reason: Washing clothes, towels, and sheets in hot water is an important part of the education for a client with scabies, as it helps to get rid of any mites or eggs that may have been transferred to the fabrics. The items should also be dried in a hot dryer or sealed in a plastic bag for at least 72 hours.
Choice D reason: Reducing intake of refined sugar has no effect on the risk of scabies, as scabies is not caused by dietary factors, but by a parasitic infestation of the skin by the Sarcoptes scabiei mite. The mite is transmitted by direct skin-to-skin contact or by sharing personal items with an infected person.
Choice E reason: Avoiding close contact with others until treated is another key part of the education for a client with scabies, as it helps to prevent the spread of the infection to other people. The client should also inform their household members, sexual partners, and close contacts, as they may need to be treated as well.
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