A nurse is providing education to a client on how to care for their cast.
Which of the following instructions should the nurse include?
Report any change in the color or temperature of the toes on the casted extremity.
Keep the cast dry and avoid submerging it in water.
Apply lotion or powder to relieve itching under the cast.
Use a warm hair dryer to dry the cast if it gets wet.
Correct Answer : A,B
Choice A rationale
Reporting any change in the color or temperature of the toes on the casted extremity is crucial for detecting potential neurovascular compromise. Changes like pallor, cyanosis, coolness, or increased warmth can indicate impaired circulation, nerve compression, or infection, requiring immediate medical attention to prevent permanent tissue damage or complications.
Choice B rationale
Keeping the cast dry and avoiding submersion in water is essential to maintain the cast's integrity and prevent skin maceration. A wet cast can soften, lose its supportive capabilities, and become a breeding ground for bacteria or mold, leading to skin irritation, infection, or breakdown. Special covers are available for showering.
Choice C rationale
Applying lotion or powder to relieve itching under the cast is contraindicated. Lotions can soften the skin, promoting maceration and fungal growth, while powders can cake and irritate the skin. Inserting objects under the cast can also lead to skin abrasions, infections, or foreign body reactions, compromising skin integrity.
Choice D rationale
Using a warm hair dryer to dry the cast if it gets wet is generally discouraged. While a cool setting might be acceptable for some fiberglass casts, warm or hot air can cause burns to the underlying skin, especially if sensation is impaired or if the cast material is plaster, which can retain heat. Air drying or a fan on a cool setting is preferred.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A sudden drop in grades, increased absenteeism, avoidance of eye contact, and flat affect are significant behavioral and emotional changes that suggest a potential underlying mental health issue. Referring the student to a school social worker, who is trained in mental health assessments and interventions, ensures a timely and appropriate professional evaluation. Early identification and intervention are crucial for improving outcomes in adolescent mental health.
Choice B rationale
Encouraging academic breaks without addressing the root cause of the student's distress is unlikely to resolve the underlying issues. While breaks can be beneficial, they do not provide the comprehensive support needed for significant behavioral and emotional changes that suggest potential mental health concerns. This approach may delay necessary professional intervention.
Choice C rationale
Contacting the child's teacher to discuss tutoring focuses solely on the academic decline and overlooks the emotional and behavioral cues. While academic support might be needed, it does not address the possible mental health component indicated by the flat affect and avoidance of eye contact, which are often symptoms of distress.
Choice D rationale
Notifying the parent to request a medical workup is a reasonable step if a physical health issue is suspected. However, the constellation of symptoms (behavioral changes, emotional blunting, social withdrawal) more strongly points towards a mental health concern rather than a purely physical one, making a referral to a mental health professional more immediately relevant.
Correct Answer is A
Explanation
Choice A rationale
NSAIDs (Nonsteroidal Anti-inflammatory Drugs) are commonly the first-line treatment for juvenile idiopathic arthritis (JIA). They work by inhibiting cyclooxygenase enzymes (COX-1 and COX-2), thereby reducing the production of prostaglandins, which are inflammatory mediators responsible for pain, swelling, and stiffness in the joints.
Choice B rationale
Antifungal medications are used to treat fungal infections. JIA is an autoimmune inflammatory condition, not caused by fungal pathogens. Therefore, antifungal medications have no therapeutic role in the management of juvenile idiopathic arthritis.
Choice C rationale
Antibiotics are specifically designed to combat bacterial infections. JIA is an autoimmune disease where the body's immune system mistakenly attacks its own tissues, primarily joints. It is not caused by bacteria, so antibiotics are ineffective for its treatment.
Choice D rationale
Antiviral medications are used to treat viral infections. JIA is not caused by viral pathogens but rather by an autoimmune dysfunction. Therefore, antiviral medications do not play a role in the primary management of juvenile idiopathic arthritis.
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