NCLEX-RNBasic Care and ComfortHard
A client who twisted an ankle 30 minutes ago has significant swelling and reports pain rated 7/10. Which non-pharmacologic intervention should the nurse implement first?
- AApply an ice pack wrapped in a towel to the ankle for 20 minutes
- BApply a warm compress to the ankle to increase blood flow and healing
- CMassage the swollen area firmly to reduce fluid accumulation
- DEncourage the client to bear weight on the ankle to maintain mobility
Show answer & explanationAnswer & explanation
Correct answer: A. Apply an ice pack wrapped in a towel to the ankle for 20 minutes
Cold therapy applied within the first 24-48 hours after an acute musculoskeletal injury causes vasoconstriction, which reduces swelling, inflammation, and pain; heat, weight-bearing, and massage are contraindicated in the acute phase because they increase blood flow and swelling.
Why the other options are wrong
- B. Heat increases vasodilation and would worsen swelling in the acute phase.
- C. Massaging an acute injury can increase inflammation and bleeding into tissue.
- D. Weight-bearing on an acutely injured ankle risks further tissue damage.
Cold vs. Heat Therapy
Application of temperature-based non-pharmacologic pain relief; cold is used for acute injury/inflammation, heat is used for chronic pain/muscle relaxation.
- Cold therapy: use within first 24-48 hours of acute injury, vasoconstriction reduces swelling
- Heat therapy: use for chronic pain or muscle stiffness, promotes vasodilation and relaxation
- Always wrap ice packs in a towel to prevent frostbite/skin damage
Memory trick: Ice it right after — heat comes later.