CNA Certification (Written Exam)Basic Nursing SkillsMedium
A nurse aide is assisting a resident who has a new cast on their lower leg. Which observation should be immediately reported to the nurse?
- AThe resident complains of mild itching under the cast.
- BThe resident states the cast feels a little heavy.
- CThe resident asks for an extra pillow to elevate the leg.
- DThe resident's toes on the casted leg appear slightly swollen and cool to the touch.
Show answer & explanationAnswer & explanation
Correct answer: D. The resident's toes on the casted leg appear slightly swollen and cool to the touch.
Swelling, coolness, and changes in color (like pallor or cyanosis) of the extremities distal to a cast are signs of impaired circulation, which is a medical emergency requiring immediate nursing intervention to prevent serious complications like tissue damage.
Why the other options are wrong
- A. Mild itching is a common, though uncomfortable, complaint with casts and generally does not indicate an emergency.
- B. A cast feeling heavy is a normal sensation due to its weight and material, not an indicator of a complication.
- C. Elevating the leg can help reduce swelling and is often a recommended action, not an immediate reportable concern unless the resident cannot achieve it.
Cast Complications: Circulatory Impairment
Serious complications of a cast include impaired circulation, which can lead to tissue damage and loss of limb function if not addressed promptly.
- Signs include swelling, coolness, pallor/cyanosis, numbness, tingling, and severe pain.
- These signs indicate a medical emergency.
- Nurse aides must report these observations immediately.
Memory trick: Casts Can Cause Critical Circulation Challenges.