The nurse is caring for a client who fractured her leg in a motor vehicle accident. A cast is applied. The nurse will assess which of the following? Select all that apply.
assess for pain, numbness, tingling, or inability to move the toes
Numbers 1, 2, 3, and 5 are correct.
Pulses and capillary refill are assessed and compared to the unaffected limb. Pulses should be equal in both feet, with brisk capillary refill. The skin should be warm. The nurse should assess the client’s pain and ask her to report numbness, tingling, or inability to move the toes. Decreased pulses or capillary refill, cool skin, and changes in sensation and movement indicate a possible complication. The client is at risk of necrosis if unusual findings are not reported immediately. The nurse should not squeeze the cast for any reason. The cast can take 24 – 48 hours to completely harden, and squeezing it can create pressure points inside that can damage the skin.
