A nurse is providing teaching for a client who has a new application of a long leg cast. Which of the following instructions should the nurse include?

Rationale: A. Use a cotton-tip applicator to relieve itching inside the cast: Inserting objects into the cast to scratch can damage the underlying skin, introduce infection, or create pressure points that lead to skin breakdown. Clients should be taught to gently tap the cast or use a hair dryer on a cool setting to relieve itching without inserting foreign objects. B. Keep the casted leg flat for the first 24 hr: Elevation, rather than keeping the leg flat, is recommended during the first 24–48 hours to reduce edema and prevent circulatory compromise. Elevating the leg above heart level promotes venous return and minimizes swelling that can cause discomfort or compromise tissue perfusion. C. Apply a heating pad to the casted leg: Applying external heat to a new cast is unsafe because it can cause burns due to insulation from the cast material. Heat can also dry the cast too quickly, leading to cracking or weakening of the cast structure. Clients should avoid using heating devices directly on the cast. D. Report any drainage from the casted leg: Drainage through the cast can indicate underlying infection, skin breakdown, or a compromised cast fit. Clients should notify the nurse or provider immediately if they observe any wetness, foul odor, or staining on the cast to allow prompt assessment and intervention.