A nurse is caring for a client following application of a cast. Which of the following actions should the nurse take first?

A. Teach the client to keep the cast clean and dry: While client education is important, it is not the immediate priority. Ensuring neurovascular integrity takes precedence over teaching after cast application. B. Palpate the pulse distal to the cast: Assessing circulation, sensation, and movement distal to the cast is the first action to identify potential complications such as compartment syndrome or impaired perfusion. Early detection of neurovascular compromise is critical to prevent tissue damage. C. Position the casted extremity on a pillow: Elevating the extremity helps reduce edema and discomfort, but it is secondary to assessing distal circulation to ensure the extremity is receiving adequate blood flow. D. Place an ice pack over the cast: Applying ice can decrease swelling and pain; however, neurovascular assessment must be completed first to ensure that cold therapy does not mask or worsen compromised circulation.