A nurse in an assisted living facility is collecting data from an older adult client who fell in their room and hit their head on the dresser. Which of the following findings is the nurse's priority?

Choice A reason:
Pinning the tubing to the client's bed sheets is not recommended as it can cause tension on the tube, potentially leading to dislodgement or damage to the tube. The tubing should be secured in a manner that allows some mobility without causing undue stress on the chest tube insertion site.

Choice B reason:
Replacing the unit when the drainage chamber is full is essential to maintain the functionality of the closed-chest tube drainage system. A full drainage chamber can prevent further collection of fluid or air, compromising the system's ability to maintain negative pressure in the pleural space, which is necessary for lung re-expansion.

Choice C reason:
Clamping the tube for 30 minutes every 6 hours is not a standard practice and could be dangerous. Clamping a chest tube without a physician's order or not in preparation for removal can lead to tension pneumothorax, especially if the patient has ongoing air leaks.

Choice D reason:
Monitoring for at least 150 mL of drainage every hour is not a specific action that should be taken. The amount of drainage should be monitored, but there is no standard amount that applies to all patients. Excessive drainage should be reported, as it may indicate hemorrhage or other complications.

Title: Choice A reason:
Immobilizing the client's fingers using a hand splint is not typically recommended for a distal radius fracture with a short arm cast. The immobilization of fingers can lead to stiffness and reduce the range of motion, which is not desirable in the early stages of healing. The fingers should be left free to allow for movement and prevent stiffness.

Choice B reason:
Positioning the fractured arm below the level of the client's heart is not advised as it can increase swelling and delay healing. The arm should be elevated above the level of the heart to reduce swelling and promote venous return.

Choice C reason:
Using a hair dryer to blow hot air into the cast is not recommended because it can cause burns and does not address the underlying cause of the itching. Instead, cool air from a hair dryer can be used to relieve itching without the risk of burns. It is important to use the cool setting to avoid any thermal injury to the skin.

Choice D reason:
Performing neurovascular checks of the affected extremity every 2 hours is essential for monitoring the status of circulation and nerve function. This frequent assessment helps in early detection of complications such as compartment syndrome or ischemia, which can occur after a fracture and cast application. Neurovascular assessments typically include checking for pulses, capillary refill, skin color, temperature, sensation, and motor function.