What critical observation should a nurse make regarding a client’s extremities with a recent cast?

A critical observation that a nurse should make regarding a client’s extremities with a recent cast is swelling beyond the cast. Following the application of a cast, it is important to monitor for swelling as it can indicate complications such as compartment syndrome, which is a medical emergency. Compartment syndrome occurs when increased pressure within a muscle compartment decreases blood flow and can lead to ischemia and muscle and nerve damage. If swelling occurs, it may signal that the cast is too tight or that there is excessive fluid accumulation, necessitating prompt intervention to relieve the pressure.

Monitoring for skin rashes, signs of infection, and fluid draining from the cast are also important, but these observations do not carry the same immediate risk to the client’s limb as swelling. While signs of infection and skin integrity are vital for long-term recovery, the immediate concern after casting is to ensure adequate circulation and prevent irreversible damage due to swelling. Thus, the ability to recognize and address swelling is paramount in post-cast care.