What is the most appropriate initial diagnostic study for suspected fractures?

Severe pain, pallor (pale skin color), and loss of pulses distal to the fracture are concerning signs of compartment syndrome, a serious complication that requires immediate medical intervention.

a. Bruising and discoloration at the fracture site: Bruising and discoloration are common signs of inflammation and injury at the fracture site but are not specific to compartment syndrome.
b. Mild pain and swelling in the affected limb: Mild pain and swelling are expected with a fracture but do not raise immediate concerns for compartment syndrome.
c. Prolonged capillary refill distal to the fracture: Prolonged capillary refill time may indicate reduced blood flow but is not as concerning as the combination of severe pain, pallor, and loss of pulses seen in compartment syndrome.

The nurse should instruct the patient to avoid placing any objects under the cast to prevent skin irritation, damage to the cast, and potential introduction of bacteria or contaminants.

a. Encouraging the patient to frequently remove the cast for skin care is not recommended, as it can compromise the cast's fit and function and increase the risk of complications.
b. Advising the patient to use a hairdryer on the cast to relieve itching is not recommended, as it can cause skin maceration and damage the cast.
d. Educating the patient to keep the cast exposed to air for prolonged periods is not recommended, as dirt and debris can get trapped inside the cast, increasing the risk of infection. The patient should follow the healthcare provider's instructions for cast care.