A nurse is reinforcing teaching with a client who is to have plaster cast applied to his right arm. Which of the following information should the nurse include the teaching?

The client should use a hair dryer on a warm setting to relieve itching inside the cast.

The client can shower with the cast after 24 hr.

The client’s extremity should be elevated after the cast applied.

The client should keep the cast covered until it is dry

Answer and Explanation

The Correct Answer is C

A) "The client should use a hair dryer on a warm setting to relieve itching inside the cast.": Using a hair dryer on a warm setting to relieve itching inside the cast is not recommended because it could potentially lead to burns or skin irritation. The client should avoid inserting objects inside the cast to scratch, as this could damage the skin or cause an infection.

B) "The client can shower with the cast after 24 hr.": A plaster cast is not waterproof, and the client should avoid getting it wet. Although the cast may feel dry on the outside after 24 hours, it typically takes about 48 hours or longer for a plaster cast to fully dry and harden. Showering with a plaster cast is not safe, as moisture could cause skin irritation or lead to the development of sores or infection.

C) "The client’s extremity should be elevated after the cast is applied.": Elevating the extremity after a cast is applied is a key teaching point to help reduce swelling and improve circulation. This is especially important during the first 24 to 48 hours after cast application. Elevation helps to prevent or manage swelling, which can be a common complication after an injury and cast application.

D) "The client should keep the cast covered until it is dry.": While it is important to keep a cast clean and dry during the drying process, the cast should not be covered with plastic or other materials that could trap moisture. The cast needs air circulation to dry properly, and covering it could lead to the cast becoming too moist, increasing the risk of skin issues or infection.

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Correct Answer is B

Explanation

A) Prolonged PT/INR:
A prolonged PT/INR is typically associated with liver dysfunction or clotting disorders. While pancreatitis can lead to complications like bleeding, it does not directly cause a prolonged PT/INR. In the case of pancreatitis, the main concerns are related to enzymes, fluid and electrolyte imbalances, and potential organ dysfunction, but clotting issues are not a primary diagnostic feature.

B) Elevated lipase:
This is the most characteristic lab finding in pancreatitis. Lipase is an enzyme produced by the pancreas, and its levels rise significantly when the pancreas is inflamed. Elevated lipase levels are a key diagnostic indicator of pancreatitis, often seen alongside elevated amylase levels. This finding helps confirm the diagnosis and monitor the severity of the condition.

C) Decreased albumin:
Decreased albumin levels are typically seen in conditions that affect liver function, kidney disease, or malnutrition. While pancreatitis can lead to some degree of malnutrition or fluid shifts, a decreased albumin level is not a specific or expected finding in pancreatitis itself. The focus is more on enzyme levels and possible complications like hypocalcemia or hyperglycemia.

D) Elevated ammonia:
Elevated ammonia levels are generally indicative of liver dysfunction or hepatic encephalopathy, which occurs in severe liver disease. While pancreatitis can cause systemic complications, an elevated ammonia level is not a typical lab finding associated with pancreatitis. Ammonia is more commonly monitored in cases of liver failure or cirrhosis.

A. Tape the tube to the child's cheek. B. Secure the tubing to the child's abdomen. C. Apply water-soluble lubricant to the site. D. Attach an extension tube to the site's opening prior to use.

Correct Answer is B

Explanation

A) "Tape the tube to the child's cheek."
Taping the tube to the child's cheek is not appropriate for securing a gastrostomy enteral tube. The tube should be securely anchored to the child's abdomen to prevent dislodgment or irritation. Taping to the cheek can lead to unnecessary friction or skin breakdown.

B) "Secure the tubing to the child's abdomen."
The proper method to secure a gastrostomy tube is to anchor the tubing to the child’s abdomen with a specialized securing device or adhesive bandage. This ensures the tube remains in place, minimizing movement and preventing irritation or accidental removal. Proper securing also promotes comfort and safety for the child.

C) "Apply water-soluble lubricant to the site."
Water-soluble lubricant should not be applied directly to the gastrostomy site. This can cause irritation or create a barrier that inhibits proper healing. Instead, the site should be kept clean and dry, with appropriate care to prevent infection or breakdown.

D) "Attach an extension tube to the site's opening prior to use."
While attaching an extension tube may be necessary for feeding or drainage, this action is not related to site care. The focus of site care is to ensure the gastrostomy tube remains securely in place, and the skin around the site is maintained without infection or irritation. Extension tubes are used for feeding or medication administration, not for routine site care.

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A nurse is reinforcing teaching with a client who is to have plaster cast applied to his right arm. Which of the following information should the nurse include the teaching?

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