Author Question: The nurse working in the emergency department (ED) is providing discharge teaching for a client with ... (Read 99 times)

scienceeasy · **on:** Jun 25, 2018

The nurse working in the emergency department (ED) is providing discharge teaching for a client with a newly applied cast to the left arm. Which statement by the client indicates additional teaching is required?

1. When I take a shower, I will put a plastic bag over my cast and keep it dry.
2. When my fingers feel cold, I will cover them with a blanket.
3. I will go home today and put ice on the cast over the fracture and prop it on pillows.
4. If I lose sensation in my fingers, I will call my doctor.

Question 2

The nurse would anticipate a plaster cast would be used for which client?

1. The client with a diagnosis of amyotrophic lateral sclerosis (ALS)
2. The client who had a compound fracture and multiple lacerations
3. The older adult client with muscle wasting secondary to cancer
4. The client with a fractured femur who plans to return to construction work before cast removal

wergv · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 2

The client needs to understand the importance of performing neurovascular checks, and of the signs of compromise, including cold, pale fingers. The nurse would instruct the client that if the fingers of the casted arm feel colder than the other hand, the health care provider should be notified. All of the other statements would reflect understanding of home care.

Answer to Question 2

Correct Answer: 2

Plaster casts are used when a window must be cut in the cast to monitor wound healing, such as with the client with the compound fracture and multiple lacerations. The client with ALS or muscle wasting would benefit from the lighter weight of the synthetic casts, and the construction worker who plans to return to work would benefit from the synthetic cast's ability to tolerate moisture.