The nurse is caring for a client after an open reduction to the left ulna. The client’s left arm is in a plaster cast with an Ace wrap for reinforcement. Which intervention by the nurse can offer nonpharmacological comfort to this client?
elevate the left arm on a pillow and apply an ice pack over the approximate location of the surgical incision
call the physician and obtain an order for acetaminophen (Tylenol) 650 mg PO PRN
q6 hours as needed for pain
advise the client that if he starts to itch under the cast, he can use a wire coat hanger or an ink pen to gently scratch up under the cast
perform range-of-motion exercises twice a shift, including bending the fingers, opening and closing the hand, and lifting the arm up to shoulder level
Number 1 is correct.
Elevating the arm and applying ice packs over the approximate location of the incision can help minimize swelling and pain. Option 2 is incorrect because the goal of the intervention is to use nonpharmacological comfort measures. Option 3 is incorrect because no foreign objects should ever be inserted into a cast. If the client is itching, suggest blowing cool air into the cast with a blow dryer. The air must be cool in order to avoid burning the skin or increasing the pain. While range-of-motion exercises are important to maintain mobility, this intervention will not promote comfort and may in fact temporarily increase client discomfort.
