An older adult patient has been casted for a fractured left wrist. Which action by the nurse takes priority?
a. Assessing capillary refill in the nail beds of the fingers of the left hand.
b. Instructing the patient on how to effec-tively rate pain on the pain scale.
c. Teaching the patient to wrap the cast in plastic when the patient showers.
d. Providing the patient with a pro-tein-enriched milkshake as a bedtime snack.
A
Excessive constriction caused by the cast could result in compartment syndrome, leading to ischemia and tissue destruction of the extremity. Any change in capillary refilling, skin color, skin temperature, or excessive pain not controlled with medication should be immediately reported to the physician. This is the priority assessment. Pain is another important assessment, but circulatory status is first. The other actions are appropriate but not the priority.
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