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A client is experiencing numbness and tingling distal to a new arm cast with no increase in pain. The nurse assesses that the client's fingers are pale, cool, and swollen. What action does the nurse take next?

Choice A reason: Cleansing the skin around the pins is the action that the nurse takes first, because it is the most urgent and relevant action. Cleansing the skin around the pins is a procedure that involves removing any dirt, debris, or secretions from the pin sites, which can help prevent or treat infection, inflammation, or pain. Cleansing the skin around the pins is a priority intervention, as it can reduce the risk of complications, such as osteomyelitis, sepsis, or pin loosening.

Choice B reason: Collecting a culture of the purulent fluid is not the action that the nurse takes first, because it is not the most urgent and relevant action. Collecting a culture of the purulent fluid is a procedure that involves obtaining a sample of the pus from the pin sites and sending it to the laboratory for analysis, which can help identify the type and source of infection. Collecting a culture of the purulent fluid is an important intervention, but it should be done after cleansing the skin around the pins, and with a medical order and a sterile technique.

Choice C reason: Administering an antibiotic is not the action that the nurse takes first, because it is not the most urgent and relevant action. Administering an antibiotic is a procedure that involves giving the client an antimicrobial agent, which can help fight or prevent infection. Administering an antibiotic is an important intervention, but it should be done after cleansing the skin around the pins, and with a medical order and a proper route.

Choice D reason: Instructing the client to complete exercises of the affected extremity is not the action that the nurse takes first, because it is not the most urgent and relevant action. Instructing the client to complete exercises of the affected extremity is a procedure that involves teaching the client how to move and strengthen the muscles and joints of the limb in traction, which can help prevent or treat atrophy, contracture, or thrombosis. Instructing the client to complete exercises of the affected extremity is an important intervention, but it should be done after cleansing the skin around the pins, and with a medical order and a safe technique.

Choice A reason: Capillary refill is not the nurse's priority assessment for this client, because it is not the most relevant and sensitive indicator of the client's condition. Capillary refill is a test that measures the time it takes for the color to return to the nail bed after applying pressure, which reflects the peripheral circulation and tissue perfusion. Capillary refill can be affected by factors such as temperature, hydration, or vasoconstriction. Capillary refill is not a specific or reliable sign of PCP, which is a type of pneumonia caused by a fungus that affects the lungs and respiratory system.

Choice B reason: Radial pulses are not the nurse's priority assessment for this client, because they are not the most relevant and sensitive indicator of the client's condition. Radial pulses are the beats that can be felt at the wrist, which reflect the heart rate and rhythm. Radial pulses can be affected by factors such as activity, emotion, or medication. Radial pulses are not a specific or reliable sign of PCP, which is a type of pneumonia caused by a fungus that affects the lungs and respiratory system.

Choice C reason: Lung sounds are the nurse's priority assessment for this client, because they are the most relevant and sensitive indicator of the client's condition. Lung sounds are the noises that can be heard with a stethoscope over the chest, which reflect the air movement and ventilation in the lungs and airways. Lung sounds can reveal the presence of abnormalities, such as crackles, wheezes, or diminished breath sounds, which indicate fluid, inflammation, or obstruction in the lungs or airways. Lung sounds are a specific and reliable sign of PCP, which is a type of pneumonia caused by a fungus that affects the lungs and respiratory system.

Choice D reason: Skin turgor is not the nurse's priority assessment for this client, because it is not the most relevant and sensitive indicator of the client's condition. Skin turgor is a test that measures the elasticity of the skin, which reflects the hydration and fluid status of the body. Skin turgor can be affected by factors such as age, weight loss, or edema. Skin turgor is not a specific or reliable sign of PCP, which is a type of pneumonia caused by a fungus that affects the lungs and respiratory system.