A home care nurse is visiting a diabetic client with a new cast on the arm. On assessment, the nurse finds the client's fingers to be pale, cool, and slightly swollen. What is the nurse's best first action?
A. Elevate the arm above the level of the heart.
B. Withhold the next dose of insulin.
C. Apply heat to the affected hand.
D. Bivalve the cast.
A
Arm casts can impinge circulation when in the dependent position. The nurse should elevate the arm above the level of the heart, ensuring that the hand is above the elbow, and reassess the ex-tremity in 15 minutes. If the fingers are warmer and less swollen, the cast is not too tight and ad-justments do not need to be made.
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