What would cause a nurse to suspect that an infection has developed under a cast?
a. Complaint of paresthesia c. Increased respirations
b. Cold toes d. "Hot spots" felt on cast surface
ANS: D
If hot spots are felt on the cast surface, they usually indicate infection beneath the area. This should be reported so a window can be made in the cast to observe the site. The "five Ps" of ischemia from a vascular injury include pain, pallor, pulselessness, paresthesia, and paralysis. Paresthesia is an indication of vascular injury, not infection. Cold toes may be indicative of too tight a cast and need further evaluation. Increased respirations may indicate a respiratory infection or pulmonary emboli. This should be reported, and the child should be evaluated.
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