Page 1140 - Saunders Comprehensive Review For NCLEX-RN

d. Monitor the extremity for circulatory
impairment, such as pain greater than
that expected for the type of injury,
edema, rubor, pallor, numbness and
tingling, coolness, decreased sensation
or mobility, or diminished pulse.
e. Notify the PHCP if circulatory
impairment occurs.
f. Prepare for bivalving or cutting the cast
if circulatory impairment occurs;
prepare for emergency fasciotomy if
cast removal does not improve the
neurocirculatory compromise.
g. Instruct parents and child not to stick
objects down the cast.
h. Teach parents and child to keep the cast
clean and dry.
i. Instruct parents and child in isometric
exercises to prevent muscle atrophy.

Box 39-1

Degrees of Developmental Dysplasia of the Hip

Acetabular Dysplasia (Preluxation)

▪ Mildest form
▪ Neither subluxation nor dislocation

▪ Delay in acetabular development occurs
▪ Femoral head remains in acetabulum

Subluxation

▪ Incomplete dislocation of the hip
▪ Femoral head remains in acetabulum
▪ Stretched capsule and ligamentum teres causes head of the femur to be partially
displaced

Dislocation

▪ Femoral head loses contact with acetabulum and is displaced posteriorly and
superiorly over fibrocartilaginous rim
▪ Ligamentum teres is elongated and taut

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