A client with an arm cast complains to you of severe pain in the affected extremity and decreased sensation and motion. Swelling in the fingers is also increased. Which of the following actions would you do first?
  1. Elevate the arm.
  2. Remove the cast.
  3. Massage the fingers.
  4. Report observations to the nurse.
Explanation
Answer: D - This observation should be reported to the nurse because the cast may be too tight and may need to be split or removed by the physician. The arm should already be elevated. The physician is notified by the nurse when circulation, sensation, or motion is impaired. Massaging the fingers is not a correct intervention.
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