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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

A. Sinus tachycardia with rates faster than 100/min: Sinus tachycardia is typically a physiologic response to stress, fever, or pain and is not an indication for permanent pacemaker placement. It usually resolves with treatment of the underlying cause.

B. Asymptomatic second-degree AV block: Asymptomatic second-degree AV block, especially type I (Mobitz I), often does not require a pacemaker and can be monitored. Intervention is indicated primarily if symptoms develop or if there is progression to a higher-degree block.

C. Vasovagal bradycardia without syncope: Vasovagal bradycardia without syncope is generally benign and does not require pacemaker placement. Treatment focuses on managing triggers rather than device therapy.

D. Complete AV block with rates slower than 40/min: A complete (third-degree) AV block with significant bradycardia is an indication for permanent pacemaker placement. The pacemaker restores adequate heart rate and cardiac output, preventing symptoms such as syncope, fatigue, or heart failure.

A. Decrease intake of fresh fruits or vegetables. B. Decrease time spent outdoors. C. Limit engaging in sport activities that can cause bruising D. Limit socializing in large crowds.

Correct Answer is B

Explanation

A. Decrease intake of fresh fruits or vegetables: Clients receiving radiation therapy do not need to reduce intake of fresh fruits or vegetables, as these foods provide essential nutrients that support healing and overall health. Nutrition should be maintained to promote tissue repair and immune function.

B. Decrease time spent outdoors: Radiation therapy can make the skin more sensitive to sunlight, increasing the risk of burns or irritation. Clients should limit sun exposure, wear protective clothing, and use sunscreen to protect areas receiving radiation.

C. Limit engaging in sport activities that can cause bruising: While bleeding risk is more relevant to clients receiving chemotherapy that affects platelet counts, radiation therapy alone does not require limiting physical activities that may cause bruising. Normal exercise is generally encouraged as tolerated.

D. Limit socializing in large crowds: Radiation therapy does not directly suppress the immune system, so avoiding crowds is not necessary unless the client is also receiving immunosuppressive treatment.

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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?

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