Page 2110 - Saunders Comprehensive Review For NCLEX-RN
P. 2110

after a fracture or injury.

                                                      2. Interventions

                                                             a. Keep the cast and extremity elevated.
                                                             b. Allow a wet plaster cast 24 to 72 hours
                                                                to dry (synthetic casts dry in 20
                                                                minutes).
                                                             c. Handle a wet plaster cast with the
                                                                palms of the hands (not fingertips)
                                                                until dry.
                                                             d. Turn the extremity every 1 to 2 hours,
                                                                unless contraindicated, to allow air
                                                                circulation and promote drying of the
                                                                cast.
                                                             e. A hair dryer can be used on a cool
                                                                setting to dry a plaster cast (heat
                                                                cannot be used on a plaster cast,
                                                                because the cast heats up and burns
                                                                the skin).
                                                             f. Monitor closely for circulatory
                                                                impairment; prepare for bivalving or
                                                                cutting the cast if circulatory
                                                                impairment occurs.
                                                             g. Petal the cast or apply moleskin to the
                                                                edges to protect the client’s skin;
                                                                maintain smooth edges around the cast
                                                                to prevent crumbling of the cast
                                                                material.
                                                             h. Monitor for signs of infection such as
                                                                increased temperature, hot spots on
                                                                the cast, foul odor, or changes in pain.
                                                             i. If an open draining area exists on the
                                                                affected extremity, the PHCP will
                                                                make a cutout portion of the cast
                                                                known as a window, for assessment and
                                                                wound care purposes.
                                                             j. Instruct the client not to stick objects
                                                                inside the cast.
                                                             k. Teach the client to keep the cast clean
                                                                and dry.
                                                             l. Instruct the client in isometric exercises
                                                                to prevent muscle atrophy.



                                                                       Monitor a casted extremity for circulatory

                                                                impairment such as pain, swelling, discoloration,
                                                                tingling, numbness, coolness, or diminished pulse.
                                                                Notify the PHCP immediately if circulatory


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