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.