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A patient was fitted with an arm cast after fracturing her humerus. Twelve hours after the application of the cast, the patient tells the nurse that her arm hurts. Analgesics do not relieve the pain. What would be the most appropriate nursing action?

User Charisma
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Final answer:

To provide thorough care, a nurse should assess the patient's arm for compartment syndrome, a condition that causes severe pain and can lead to serious complications if not treated urgently. This includes checking for pain beyond the fracture site and signs of nerve or muscle damage. If signs are detected, immediate medical intervention is vital.

Step-by-step explanation:

If a patient reports arm pain that persists 12 hours after the application of a cast and is not relieved by analgesics, the most appropriate nursing action would be to assess the patient's arm for signs of compartment syndrome. This condition is a serious medical emergency where pressure builds up within the muscles, which can decrease blood flow, prevent nourishment from reaching nerve and muscle cells, and potentially cause damage. The nurse should check for the '5 P's' of compartment syndrome: pain, paresthesia (tingling or burning sensations), paralysis, pallor, and pulselessness. If these symptoms are present, the nurse should immediately alert the healthcare provider, as surgical intervention may be required to relieve the pressure.

It is important to recognize that pain can extend beyond the fracture site due to associated muscle or ligament injuries. Therefore, even in the absence of compartment syndrome, the nurse should perform a thorough assessment and monitoring of the patient's pain and other symptoms. Furthermore, adequate physical therapy and care are essential following the treatment of a fracture. The appropriate physical therapy plan typically includes a warm-up with a heat pack, targeted exercises, and icing to manage inflammation and swelling, all of which contribute to healing and restoring normal function over time.

User Jpadvo
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