A phone triage nurse speaks with a client who has an arm cast. The client states, "My arm feels really tight and puffy." How should the nurse respond?
a. "Elevate your arm on two pillows and get ice to apply to the cast."
b. "Continue to take ibuprofen (Motrin) until the swelling subsides."
c. "This is normal. A new cast will often feel a little tight for the first few days."
d. "Please come to the clinic today to have your arm checked by the provider."
ANS: D
Puffy fingers and a feeling of tightness from the cast may indicate the development of compartment syndrome. The client should come to the clinic that day to be evaluated by the provider because delay of treatment can cause permanent damage to the extremity. Ice and ibuprofen are acceptable actions, but checking the cast is the priority because it ensures client safety. The nurse should not reassure the client that this is normal.
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