An infant returns to the unit following surgical correction of bilateral congenital clubfeet. The infant has bilateral long-leg casts. The nurse notes that the toes on both feet are edematous, but there is color, sensitivity, and movement to them. Which action by the nurse is the priority?
1. Apply a warm, moist pack to the feet.
2. Elevate the legs on pillows.
3. Encourage movement of the toes.
4. Call the surgical provider to report the edema.
2
Explanation:
1. Warm, moist heat will increase swelling and the moisture may cause the cast to disintegrate.
2. The infant's legs should be elevated on a pillow for 24 hours to promote healing and help with venous return. This is the priority action.
3. An infant would not be able to follow directions to move the toes, and in this case it would not be as effective as would elevating the legs on pillows.
4. Some amount of swelling can be expected, so it would not be appropriate to notify the physician, especially if the color, sensitivity, and movement to the toes remained normal.
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