A nurse cares for a client who had a wrist cast applied 3 days ago. The client states, "The cast is loose enough to slide off." How should the nurse respond?
a. "Keep your arm above the level of your heart."
b. "As your muscles atrophy, the cast is expected to loosen."
c. "I will wrap a bandage around the cast to prevent it from slipping."
d. "You need a new cast now that the swelling is decreased."
ANS: D
Often the surrounding soft tissues may be swollen considerably when the cast is initially applied. After the swelling has resolved, if the cast is loose enough to permit two or more fingers between the cast and the client's skin, the cast needs to be replaced. Elevating the arm will not solve the problem, and the client's muscles should not atrophy while in a cast for 6 weeks or less. An elastic bandage will not prevent slippage of the cast.
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