A nurse is caring for a client who has been diagnosed with psoriasis. The nurse is creating an education plan for the client. What information should be included in this plan?

Choice A reason: Reporting any pain that is uncontrolled by elevating the affected limb or by analgesic agents is an appropriate teaching point for the nurse to emphasize, as it may indicate a serious complication such as compartment syndrome, infection, or nerve damage. The nurse should instruct the client to notify the health care provider immediately if the pain persists or worsens.

Choice B reason: Using intermittent heat packs as prescribed to control swelling is not an appropriate teaching point for the nurse to emphasize, as it may increase the blood flow and inflammation in the affected area. The nurse should advise the client to avoid heat sources such as heating pads, hot water bottles, or electric blankets, as they may also damage the cast or cause burns.

Choice C reason: Using a small hair brush to control any itching under the cast is not an appropriate teaching point for the nurse to emphasize, as it may cause skin irritation, infection, or damage to the cast. The nurse should suggest the client to use a cool air dryer, a gentle tapping, or an antihistamine to relieve the itching, and to avoid inserting any objects under the cast.

Choice D reason: Keeping the affected extremity below the level of the heart to prevent swelling is not an appropriate teaching point for the nurse to emphasize, as it may impair the venous return and increase the edema. The nurse should recommend the client to elevate the affected extremity above the level of the heart to reduce the swelling and promote the healing.

Choice E reason: Inspecting the cast daily for cracks, breaks, or signs of infection is not an appropriate teaching point for the nurse to emphasize, as it is not a specific or relevant instruction for the client with a cast on his leg. The nurse should teach the client to keep the cast dry and clean, to cover it with a plastic bag when showering or bathing, and to report any foul odor, drainage, or fever.

Choice A reason: Heat rash is not an early sign of a fat embolus, as it is a skin condition that occurs when the sweat ducts are blocked and the sweat cannot evaporate. Heat rash is more common in hot and humid environments, and it causes red, itchy, or prickly bumps on the skin. Heat rash is not related to a fat embolus, which is a serious complication of a fracture that involves the release of fat droplets into the bloodstream.

Choice B reason: Tachypnea is an early sign of a fat embolus, as it indicates a respiratory distress that may be caused by the fat droplets blocking the pulmonary capillaries. Tachypnea is a rapid breathing rate that exceeds 20 breaths per minute, and it may be accompanied by dyspnea, chest pain, cough, or hemoptysis. Tachypnea is a sign of hypoxemia, which is a low level of oxygen in the blood, and it requires immediate intervention.

Choice C reason: Bradycardia is not an early sign of a fat embolus, as it is a slow heart rate that is below 60 beats per minute. Bradycardia may be caused by various factors, such as medication, heart disease, hypothyroidism, or vagal stimulation. Bradycardia is not related to a fat embolus, which is a serious complication of a fracture that involves the release of fat droplets into the bloodstream.

Choice D reason: Abdominal cramping is not an early sign of a fat embolus, as it is a pain or discomfort in the abdomen that may be caused by various factors, such as food intolerance, infection, inflammation, or obstruction. Abdominal cramping is not related to a fat embolus, which is a serious complication of a fracture that involves the release of fat droplets into the bloodstream.

Choice E reason: Confusion is not an early sign of a fat embolus, but a late sign that may indicate a cerebral involvement of the fat embolus. Confusion is a state of impaired awareness, orientation, or memory that may be caused by various factors, such as medication, infection, trauma, or hypoxia. Confusion is a sign of cerebral hypoxia, which is a low level of oxygen in the brain, and it requires immediate intervention.