Which assessment finding indicates a need for immediate nursing intervention in a patient with a cast?

The presence of a loss of pulse in the affected limb indicates a critical situation that warrants immediate nursing intervention. A pulse is a vital indicator of blood flow, and its absence suggests possible complications, such as severe swelling or internal compartment syndrome, which can lead to ischemia (lack of blood flow) and subsequent tissue damage.

In this context, the immediate nursing response would be to assess the situation further—checking for symptoms like increased pain, pallor, or paralysis—and to notify the healthcare provider to facilitate urgent intervention, such as adjusting or removing the cast. This is essential to prevent permanent damage to the limb.

While increased warmth around the cast could signal inflammation or infection and itching under the cast is uncomfortable but typically not urgent, and dry skin can indicate irritation or moisture issues, they do not convey the same level of immediate risk to the patient's limb viability as a loss of pulse does.