A nurse is providing teaching for a client who has a new application of a long leg cast. Which of the following instructions should the nurse include?
Use a cotton-tip applicator to relieve itching inside the cast.
Report any drainage from the casted leg
Keep the casted leg flat for the first 24 hr.
Apply a heating pad to the casted leg.
The Correct Answer is B
A. Use a cotton-tip applicator to relieve itching inside the cast.: Inserting any object into the cast can damage the underlying skin, cause abrasions, or introduce infection. Scratching inside the cast may also compromise cast integrity.
B. Report any drainage from the casted leg.: Drainage can indicate bleeding, wound infection, or impaired circulation under the cast, all of which require prompt evaluation. Early reporting helps prevent complications such as compartment syndrome or infection progression.
C. Keep the casted leg flat for the first 24 hr.: Elevation, not a flat position, is recommended in the first 24 to 48 hours to minimize swelling and pain. Keeping the leg flat can increase edema, which may impair circulation and delay healing.
D. Apply a heating pad to the casted leg.: External heat should be avoided because it can cause burns under the cast where the skin cannot be directly monitored. Heat also increases blood flow and swelling, which can worsen pain and increase pressure within the cast.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Blurred vision: Blurred vision is not a common adverse effect of cefaclor. Visual disturbances are typically unrelated to cephalosporin therapy, so monitoring for this symptom is not a priority during treatment.
B. Diarrhea: Diarrhea is a known adverse effect of cefaclor due to its impact on gut flora, which can lead to mild gastrointestinal upset or, in severe cases, antibiotic-associated colitis. Monitoring for changes in bowel patterns helps detect complications early and guide intervention.
C. Hypoglycemia: Hypoglycemia is not typically associated with cefaclor use. Cephalosporins do not directly affect blood glucose regulation, so routine glucose monitoring is not required unless the client has other risk factors, such as concurrent insulin therapy.
D. Photosensitivity: While some antibiotics (like tetracyclines or fluoroquinolones) can cause photosensitivity, it is not a primary or common adverse effect of cefaclor.
Correct Answer is D
Explanation
A: This tracing shows occasional premature ventricular contractions (PVCs) with normal QRS complexes, which is not characteristic of a paced rhythm. A permanent pacemaker typically produces consistent pacing spikes preceding the QRS complex.
B: This tracing demonstrates a very rapid, wide-complex rhythm consistent with ventricular tachycardia, not a normal paced rhythm. This is a potentially life-threatening arrhythmia requiring immediate intervention.
C: This tracing shows an irregular rhythm with abnormal QRS morphology, likely atrial fibrillation with conduction abnormalities. It does not show consistent pacemaker spikes before each QRS complex.
D: This tracing displays regular pacing spikes immediately preceding each QRS complex, which is expected in a client with a functioning permanent pacemaker. The spikes indicate the pacemaker is delivering electrical impulses to stimulate ventricular contraction.
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