Page 1145 - Saunders Comprehensive Review For NCLEX-RN

2. “I realize my infant will require follow-up care until fully grown.”
3. “I need to bring my infant back to the clinic in 1 month for a new
cast.”
4. “I need to come to the clinic every week with my infant for the
casting.”
402. The nurse prepares a list of home care instructions for the parents of a child
who has a plaster cast applied to the left forearm. Which instructions should
be included on the list? Select all that apply.
1. Use the fingertips to lift the cast while it is drying.

2. Keep small toys and sharp objects away from the cast.

3. Use a padded ruler or another padded object to scratch the
skin under the cast if it itches.
4. Place a heating pad on the lower end of the cast and over the

fingers if the fingers feel cold.
5. Elevate the extremity on pillows for the first 24 to 48 hours

after casting to prevent swelling.
6. Contact the primary health care provider (PHCP) if the child
complains of numbness or tingling in the extremity.

Answers

393. Answer: 4

Rationale: An absent pulse to an extremity of the affected limb after a bone
fracture could mean that the child is developing or experiencing compartment
syndrome. This is an emergency situation, and the PHCP needs to be notified
immediately. Administering analgesics would not improve circulation. The skin
traction should not be released without a PHCP’s prescription. Applying ice to an
extremity with absent perfusion will worsen the problem. Ice may be prescribed
when perfusion is adequate to decrease swelling.
Test-Taking Strategy: Use the ABCs—airway, breathing, and circulation.
Focusing on the data in the question indicates that circulation is impaired. This
should direct you to the correct option.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Complex Care: Emergency Situations/Management
Health Problem: Pediatric-Specific: Fractures
Priority Concepts: Clinical Judgment; Perfusion
Reference: McKinney et al. (2018), pp. 1213-1214.

394. Answer: 4

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