In caring for a patient with Unna's paste boot, which assessment is appropriate?

• A. Check capillary refill of toes
• B. Check lung sounds
• C. Check gag reflex
• D. Check abdominal reflexes

Answer: (A)

When you’re caring for someone with an Unna paste boot, the priority is to monitor distal circulation in the affected leg. The boot provides compression to support venous return and reduce edema, but if the bandage is too tight or swelling changes, it can compromise arterial flow to the toes. Checking capillary refill of the toes is a quick, noninvasive way to assess peripheral perfusion. To perform it, firm pressure on the toenail bed blanches the skin; when you release, the color should return in less than about 2 seconds. A delayed refill suggests impaired perfusion or excessive bandaging, signaling a need to adjust the boot or reassess the fit and circulation.

Lung sounds, gag reflex, and abdominal reflexes don’t provide information about limb circulation or the safety of compression therapy, so they aren’t appropriate assessments for this scenario.