The client tells the nurse that the top of the cast feels rough and is scratching the skin. Which intervention should the nurse implement?
1. Explain that this is an expected outcome.
2. Trim away sharp areas and edge with tape.
3. Medicate client with a prescribed analgesic.
4. Speak with the provider about a cast change.
2
2. All plaster casts have rough edges before they are "finished," and the nurse finishes the edge to prevent skin breakdown and infection. To finish the cast the nurse carefully trims away the thin, uneven edge and reinforces the edge with tape. If the cast is finished with stockinette, the provider folds over the stockinette back onto the cast and makes a final loop around the cast to hold it in place.
1. Causing client harm cannot be an expected outcome because it contradicts a prin-ciple of nursing ethics.
3. Pain medication can become necessary; however the priority is to prevent skin breakdown and infection. The discomfort will resolve after the edge is finished and edema subsides.
4. A cast change is not indicated.
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