Which instruction should a nurse include when teaching a client with a left leg cast about proper use of crutches to protect the integumentary system?

• A. Rest your armpits directly on the crutch pads for better support.
• B. Ensure the crutch pads are well-padded to prevent skin breakdown under the arms.
• C. Apply lotion inside the cast to keep the skin moisturized.
• D. Wear tight socks to prevent swelling in the foot.

Answer: (B)

Verified step by step guidance

1. Understand the role of the integumentary system: The integumentary system includes the skin, hair, nails, and associated glands. Its primary function is to protect the body from external damage, regulate temperature, and prevent dehydration. In this scenario, the focus is on preventing skin breakdown and maintaining skin health while using crutches and wearing a cast.
2. Evaluate the use of crutches: When using crutches, it is important to avoid resting the armpits directly on the crutch pads. Prolonged pressure on the skin in this area can lead to irritation, discomfort, and even skin breakdown. Instead, the crutch pads should be well-padded to distribute pressure evenly and protect the skin.
3. Consider the cast's impact on the skin: Applying lotion inside the cast is not recommended, as it can lead to moisture buildup, which may increase the risk of skin irritation or infection. The cast should remain dry to maintain its integrity and prevent complications.
4. Assess the role of socks: Tight socks can restrict circulation and potentially worsen swelling in the foot. Instead, loose-fitting socks or compression stockings (if recommended by a healthcare provider) can help manage swelling without compromising skin health.
5. Summarize proper care instructions: The nurse should emphasize the importance of ensuring crutch pads are well-padded, avoiding direct pressure on the armpits, keeping the cast dry, and wearing appropriately fitting socks to protect the skin and maintain overall integumentary health.