A nurse is assessing a client who has a cast in place for a fractured tibia. Which of the following actions should the nurse take first?

A. Stretching exercises:

Stretching exercises involve gently elongating muscles and tendons, promoting flexibility and range of motion. For individuals with osteoporosis, stretching exercises can improve balance and reduce the risk of falls, which is crucial as osteoporosis weakens bones and makes individuals more prone to fractures.
B. Riding a bicycle:

Bicycling is a low-impact cardiovascular exercise that is easy on the joints. It can help improve cardiovascular health, but it might not specifically address the balance and flexibility issues often associated with osteoporosis. However, it's a good option for overall fitness and joint health.
C. Walking briskly:

Brisk walking is an excellent low-impact aerobic exercise. It improves cardiovascular health, strengthens muscles, and aids in weight management. Walking can be adapted to various fitness levels, making it a suitable exercise for many older adults. While it doesn't specifically focus on flexibility, it promotes overall health and well-being.
D. High-impact aerobics:

High-impact aerobics involve activities like jumping, running, or intense dancing. These exercises can stress the bones and joints, potentially leading to injuries, especially for individuals with osteoporosis. High-impact exercises are generally discouraged for people with osteoporosis due to the increased risk of fractures.

A. Performing range of motion:
Explanation: Range of motion exercises are important for preventing joint stiffness and muscle atrophy, especially in clients with casts. However, this is not the first priority. Ensuring adequate circulation and perfusion is crucial before initiating any exercises or movements, as compromised circulation could lead to serious complications.

B. Managing pain:
Explanation: Pain management is important for the client's comfort, but it is not the first priority in this context. Assessing circulation and ensuring there are no signs of compromised perfusion takes precedence. Pain management can follow once circulation has been confirmed as adequate.

C. Checking capillary refill:
Explanation: Checking capillary refill is the first priority when assessing a client with a cast. Capillary refill assesses peripheral circulation by pressing on the nail bed and observing how quickly color returns. Delayed capillary refill could indicate compromised blood flow, which is a serious concern and requires immediate intervention.

D. Discussing cast care:
Explanation: Educating the client about cast care is important, but it is not the first priority. Ensuring proper circulation and ruling out any signs of impaired perfusion must be addressed before discussing cast care instructions.