One day after cast removal, the client reports mild edema and muscle spasms in the affected arm. Which instruction does the nurse provide to the client to manage the complaints? (Select all that apply.)

Question

1. Rest arm for 48 hours in a sling.
2. Take prescribed muscle relaxant.
3. Elevate arm slightly above waist.
4. Make appointment to see provider.
5. Use cool water soak for 30 minutes.
6. Apply ice pack at 20-minute intervals.

Answer 1

2, 3, 6
2, 3, and 6. Muscle spasms are a benign consequence of a fracture and can persist after cast removal; as well, edema is a benign consequence of cast removal and occurs with returning movement and function. The nurse instructs the client to take a muscle relaxant to relieve the spasm, to elevate the arm to facilitate venous return, and to apply ice to vasoconstrict, preventing additional fluid accumulation and providing a mild anesthetic effect.
1. Resting the arm promotes tissue atrophy and restricts restoration of function and appearance in the affected tissue.
4. These clinical indicators are expected benign consequences of cast removal and does not warrant an office visit.
5. Cool water immersion is contraindicated for the client with muscle spasms and edema because immersing an extremity in cool water provides deep, extensive tissue cooling indicated to stop the progression of burn injuries. In addition, the deep cool-ing can chill the client and vasoconstrict a large amount of tissue that the client can-not tolerate.