A child sustains a fall at home and is brought to the hospital emergency department by the child's mother. After a radiographic examination, the child is determined to have a fractured arm, and a plaster cast is applied. The nurse provides instructions to the mother regarding neurocirculatory assessment and function. Which statement by the mother indicates a need for further instruction?
1. "I'll need to check her skin twice a day at the cast edges." 2. "If her hand gets real cool and pale, I can apply the heating pad to it." 3. "For the first couple of days, I should try to keep her hand higher than her heart most of the time, using pillows." 4. "If she seems way too fussy and her arm is painful even after I've given her the pain medication, it might be a problem, and I should call you for help to decide on what is happening."

2. "If her hand gets real cool and pale, I can apply the heating pad to it."

Rationale:

The mother needs to understand that compartment syndrome is a complication of fracture and casting and can result in permanent limb damage as a result of pressure-related tissue necrosis. The extremity is elevated to prevent swelling, and the health care provider is notified immediately if any signs of neurovascular impairment develop. Cold fingers could indicate neurovascular impairment and should be reported. A heating pad is not applied to the cast or fingers. Skin edges are checked to monitor for irritation and skin breakdown.

the sentence that best describes the tone of the passage from the radio broadcast compared to the passage from the book is b. the radio broadcast has a more surprised tone.

consider the text evidence: in the passage from the book, the description is more matter-of-fact. it is simply describing the things resembling little grey snakes, but there is no urgency in the description. on the other hand, in the passage from the radio broadcast, there is definetely urgency (you can tell from the expression used, "good heavens", which clearly indicates surprise.)