A home health nurse assesses a client with diabetes who has a new ...

[cookcarl]

A home health nurse assesses a client with diabetes who has a new cast on the arm. The nurse notes the client's fingers are pale, cool, and slightly swollen. Which action should the nurse take first?
 
  a. Raise the arm above the level of the heart.
  b. Encourage range of motion.
  c. Apply heat to the affected hand.
  d. Bivalve the cast to decrease pressure.

Question 2

A nurse notes crepitation when performing range-of-motion exercises on a client with a fractured left humerus. Which action should the nurse take next?
 
  a. Immobilize the left arm.
  b. Assess the client's distal pulse.
  c. Monitor for signs of infection.
  d. Administer prescribed steroids.

[alexisweber49]

Answer to Question 1

ANS: A
Arm casts can impair circulation when the arm is in the dependent position. The nurse should immediately elevate the arm above the level of the heart, ensuring that the hand is above the elbow, and should re-assess the extremity in 15 minutes. If the fingers are warmer and less swollen, the cast is not too tight and adjustments do not need to be made, but a sling should be worn when the client is upright. Encouraging range of motion would not assist the client as much as elevating the arm. Heat would cause increased edema and should not be used. If the cast is confirmed to be too tight, it could be bivalved.

Answer to Question 2

ANS: A
A grating sound heard when the affected part is moved is known as crepitation. This sound is created by bone fragments. Because bone fragments may be present, the nurse should immobilize the client's arm and tell the client not to move the arm. The grating sound does not indicate circulation impairment or infection. Steroids would not be indicated.