A nurse is reinforcing teaching with a client who is to have plaster cast applied to his right arm. Which of the following information should the nurse include the teaching?

The client should use a hair dryer on a warm setting to relieve itching inside the cast.

The client can shower with the cast after 24 hr.

The client’s extremity should be elevated after the cast applied.

The client should keep the cast covered until it is dry

Answer and Explanation

The Correct Answer is C

A) "The client should use a hair dryer on a warm setting to relieve itching inside the cast.": Using a hair dryer on a warm setting to relieve itching inside the cast is not recommended because it could potentially lead to burns or skin irritation. The client should avoid inserting objects inside the cast to scratch, as this could damage the skin or cause an infection.

B) "The client can shower with the cast after 24 hr.": A plaster cast is not waterproof, and the client should avoid getting it wet. Although the cast may feel dry on the outside after 24 hours, it typically takes about 48 hours or longer for a plaster cast to fully dry and harden. Showering with a plaster cast is not safe, as moisture could cause skin irritation or lead to the development of sores or infection.

C) "The client’s extremity should be elevated after the cast is applied.": Elevating the extremity after a cast is applied is a key teaching point to help reduce swelling and improve circulation. This is especially important during the first 24 to 48 hours after cast application. Elevation helps to prevent or manage swelling, which can be a common complication after an injury and cast application.

D) "The client should keep the cast covered until it is dry.": While it is important to keep a cast clean and dry during the drying process, the cast should not be covered with plastic or other materials that could trap moisture. The cast needs air circulation to dry properly, and covering it could lead to the cast becoming too moist, increasing the risk of skin issues or infection.

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Correct Answer is A

Explanation

A) You can splint the incision with a pillow when changing position: Splinting the incision with a pillow is an excellent nonpharmacological method to manage pain during position changes after a cesarean section. The pillow helps provide support to the incision site, reduces strain on the abdominal muscles, and minimizes discomfort when the client moves. This is a safe and effective intervention to help with pain management.

B) You should change position as little as possible: While minimizing movement might seem like a way to prevent pain, it can lead to complications like muscle stiffness, poor circulation, and respiratory issues. It’s important for clients to change positions to promote comfort, circulation, and lung expansion, but they should do so with support to manage pain effectively.

C) You should use patterned paced breathing when changing positions: Patterned paced breathing is a helpful relaxation technique that can be used in various situations, including labor and delivery. However, it is not the most appropriate response in this context, as the client’s pain is more related to physical discomfort from the incision, and physical support (like splinting the incision) would be more effective in managing this type of pain.

D) You can apply counterpressure to your back with each position change: While counterpressure can be beneficial for back pain during labor, it is not the most relevant technique for managing pain after a cesarean section, where the pain is related to the abdominal incision site. Splinting the incision provides more targeted support for post-cesarean discomfort.

A. Regresses to an earlier developmental level B. Alienates himself from his peers C. Believes that his brother's death will be reversible D. Believes his bad behavior is causing his brother's death

Correct Answer is D

Explanation

A) Regresses to an earlier developmental level:
While it is possible for a child to show some regression in behavior when faced with a stressful situation such as a sibling’s illness, school-age children are typically able to understand more complex concepts. Regression to an earlier developmental stage is more common in younger children (preschool-age) rather than school-age children, who are more likely to express their emotions in other ways.

B) Alienates himself from his peers:
While the child may experience feelings of isolation or withdrawal due to the stress of a sibling’s terminal illness, alienation from peers is not the most typical or immediate response for a school-age child. It is more common for children of this age to seek comfort and support from peers, though they may struggle with how to discuss their feelings.

C) Believes that his brother's death will be reversible:
At a school-age level, children generally begin to understand the permanence of death. While younger children may have magical thinking that could lead them to believe the death of a loved one could be reversible, this is not the expected response for a school-age child. By this age, children typically comprehend that death is final, although they may struggle with the emotional aspect of it.

D) Believes his bad behavior is causing his brother's death:
This response is the most typical for a school-age child. At this stage, children often have a sense of responsibility for events around them and may develop feelings of guilt or magical thinking, where they believe their actions or behavior contributed to the illness or death of a loved one. This belief is part of the normal coping process but needs to be addressed in counseling or with support from caregivers to help the child understand the situation and alleviate any misplaced guilt.

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A nurse is reinforcing teaching with a client who is to have plaster cast applied to his right arm. Which of the following information should the nurse include the teaching?

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