A patient with a humeral fracture is returning for a 4-week checkup. The nurse explains that initial evidence of healing on x-ray is indicated by

Choice A reason: Plaster of Paris casts must be kept dry, as water weakens the material, causing breakdown or skin maceration. Covering the cast with a waterproof barrier during showering is essential. This instruction is incorrect, as it risks cast damage and skin infections, which could complicate recovery.

Choice B reason: Applying ice after walking may reduce swelling, but it is not a standard instruction for a walking cast unless edema is present. Ice can dampen the cast, risking structural integrity. Monitoring neurovascular status is more critical, making this less essential compared to reporting symptoms.

Choice C reason: A musty odor is not normal and may indicate moisture, skin breakdown, or infection beneath the cast. Patients should report odors, as they suggest complications requiring evaluation. This instruction is incorrect, as it dismisses a potential sign of serious issues like bacterial growth or tissue damage.

Choice D reason: Reporting numbness or pain in the toes is critical, as these symptoms may indicate neurovascular compromise, such as compartment syndrome or nerve compression from a tight cast. Early reporting ensures timely intervention to prevent permanent damage, making this a key instruction for safe cast management and recovery.

Choice A reason: Increasing caffeine intake is not recommended for fibromyalgia, as it can exacerbate sleep disturbances and anxiety, common in the condition. Fibromyalgia management focuses on improving sleep, reducing pain, and enhancing function through exercise and medications. This statement reflects misunderstanding, potentially worsening symptoms and hindering effective self-management strategies.

Choice B reason: Taking duloxetine in the morning is reasonable but not the best indicator of fibromyalgia teaching comprehension. Duloxetine, a serotonin-norepinephrine reuptake inhibitor, helps pain and mood but isn’t primarily for energy. This statement shows partial understanding, missing broader management strategies like exercise, which are central to fibromyalgia care.

Choice C reason: Chemotherapy is irrelevant for fibromyalgia, a non-inflammatory pain syndrome, not a malignancy. This statement indicates a significant misunderstanding of fibromyalgia’s nature and treatment, which involves exercise, medications like duloxetine, and cognitive therapies. Expecting a cure via chemotherapy misaligns expectations, delaying effective symptom management and patient education.

Choice D reason: Low-impact aerobics reduce fibromyalgia pain by improving muscle conditioning, circulation, and endorphin release, supported by evidence-based guidelines. This statement reflects understanding of nonpharmacological management, a cornerstone of fibromyalgia treatment, promoting physical function and pain relief, and aligning with comprehensive care to enhance quality of life.