Final answer:
(d) The presence of a "hot spot" on the cast is indicative of infection in a casted extremity. Other signs such as edema, diminished pulse, and skin coolness/pallor are concerning but not specifically indicative of infection.
Step-by-step explanation:
The nurse assessing a client's casted extremity for signs of infection should consider the presence of a "hot spot" on the cast as indicative of an infection. This finding suggests that there is localized inflammation that may be accompanying an infection underneath the cast, which can be a serious complication that requires immediate medical attention. Other signs of inflammation to look out for include redness, heat, swelling, and pain as these are the cardinal signs of inflammation. Notable symptoms from clinical cases include red and warm skin around a catheter site, fever, and rapid changes in the condition of the skin, such as blistering or rash development.
Options like dependent edema, diminished distal pulse, and coolness and pallor of the skin, while concerning, are not as specifically indicative of an infection as a hot spot on the cast. They could be indicative of other complications, such as circulation issues or other non-infectious inflammatory responses.