A nurse is assessing a client following the application of a leg cast for the treatment of a fracture. If the cast is too tight, which of the following findings should the nurse expect to observe first?
A.
Inability to move toes.
B.
Pallor of the toes.
C.
Change in temperature of the toes.
D.
Edema of the toes.
The answer and explanation is:
The correct answer is B. Pallor of the toes.
Explanation:
When a cast is applied to a limb, it is crucial to monitor for signs of compromised circulation, as a cast that is too tight can lead to serious complications, including tissue damage. Among the various signs that may indicate circulatory impairment, pallor of the toes is the earliest and most critical finding.
- Pallor of the Toes: Pallor refers to an abnormal paleness of the skin, which can occur when blood flow to the area is reduced. In the case of a tight cast, the pressure can impede arterial blood flow, leading to a lack of oxygen and nutrients in the tissues. This is often the first observable sign of compromised circulation, making it essential for nurses to assess the color of the toes regularly.
- Inability to Move Toes (A): While an inability to move the toes may indicate that the cast is too tight, it is not the first ign to be expected. This finding may occur later as muscle and nerve function become compromised due to prolonged pressure.
- Change in Temperature of the Toes (C): A change in temperature can indicate impaired circulation, but it typically follows the initial observation of pallor. The toes may feel cooler due to reduced blood flow, but this change may not be immediately noticeable.
- Edema of the Toes (D): Edema, or swelling, can develop as a result of increased pressure within the cast. However, it usually appears after other signs of compromised circulation, such as pallor or temperature changes.
In summary, pallor of the toes is the earliest and most critical sign of compromised blood flow due to a tight cast. Early recognition of this sign is essential for timely intervention to prevent serious complications. Regular assessments of the affected limb, including checking color, temperature, movement, and sensation, are vital for ensuring that the cast is not causing harm.