The nurse is teaching the parents of a 7-year-old child who has ...

[dmcintosh]

The nurse is teaching the parents of a 7-year-old child who has just had a cast applied for a fractured arm with the wrist and elbow immobilized. Which instructions should be included in the teaching?
 
  a. Swelling of the fingers is to be expected for the next 48 hours.
  b. Immobilize the shoulder to decrease pain in the arm.
  c. Allow the affected limb to hang down for 1 hour each day.
  d. Elevate casted arm when resting and when sitting up.

Question 2

What would cause a nurse to suspect that an infection has developed under a cast?
 
  a. Complaint of paresthesia c. Increased respirations
  b. Cold toes d. Hot spots felt on cast surface

[EAN94]

Answer to Question 1

ANS: D
The injured extremity should be kept elevated while resting and in a sling when upright. This will increase venous return. Swelling of the fingers may indicate neurovascular damage and should be reported immediately. Permanent damage can occur within 6 to 8 hours. Joints above and below the cast on the affected extremity should be moved. The child should not engage in strenuous activity for the first few days. Rest with elevation of the extremity is encouraged.

Answer to Question 2

ANS: D
If hot spots are felt on the cast surface, they usually indicate infection beneath the area. This should be reported so a window can be made in the cast to observe the site. The five Ps of ischemia from a vascular injury include pain, pallor, pulselessness, paresthesia, and paralysis. Paresthesia is an indication of vascular injury, not infection. Cold toes may be indicative of too tight a cast and need further evaluation. Increased respirations may indicate a respiratory infection or pulmonary emboli. This should be reported, and the child should be evaluated.

[dmcintosh]

TYSM

[zacnyjessica]

Excellent