The nurse is planning preoperative care for a client who has a fractured wrist. Which of the following should the nurse include in the client's plan of care?

Choice A Reason:
While performing range of motion exercises is important for maintaining joint function and preventing stiffness, it is not the first action a nurse should take. Range of motion exercises should only be performed after ensuring that there is no compromise in circulation or nerve function.

Choice B Reason:
Checking capillary refill is the correct first action. This quick test assesses the blood flow to the extremity and can indicate if there is any vascular obstruction. A delayed capillary refill time, which is more than 2 seconds, could signify compromised circulation and necessitate immediate intervention.

Choice C Reason:
Discussing cast care is important for client education and preventing complications such as skin breakdown and infection. However, it is not the first priority. The nurse should first ensure the client's physiological stability before providing education.

Choice D Reason:
Managing pain is a critical component of nursing care, especially for clients with fractures. However, the assessment of circulation takes precedence over pain management. Once it is established that there is no immediate threat to the limb's viability, pain management should be addressed promptly.

Choice A reason:
Disinfecting equipment contaminated with blood or body fluids is crucial to prevent the spread of infection, but the specific time frame of twenty-four hours is not standard practice. The Centers for Disease Control and Prevention (CDC) recommends cleaning and then disinfecting surfaces or objects that may be contaminated, using a disinfectant registered by the Environmental Protection Agency (EPA) and following the manufacturer's instructions for use.

Choice B reason:
Burning soiled dressings is not a recommended practice due to environmental concerns and potential health risks associated with burning medical waste. Instead, soiled dressings should be disposed of properly in accordance with local regulations for biohazardous waste.

Choice C reason:
Good household cleaning practices are essential for preventing the spread of infection, especially for individuals with compromised immune systems, such as those with AIDS. Regular cleaning and disinfecting of frequently touched surfaces can help reduce the risk of infection.

Choice D reason:
The statement "Food preparation is not your responsibility" is not an appropriate discharge instruction. Patients with AIDS should be informed about safe food handling practices to prevent foodborne illnesses, which they are at higher risk for due to their weakened immune systems.