Page 2110 - Saunders Comprehensive Review For NCLEX-RN

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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