What are the nurses responsibilities when a cast is applied for the patient?

SKILLS – ASSESSMENT OF A LIMB IN A CASTDigital Edition: SKILLS – ASSESSMENT OF A LIMB IN A CAST

05 August, 2003

 


Abstract
VOL: 99, ISSUE: 31, PAGE NO: 27

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This is an NCLEX cast care review question. This question provides a scenario about a patient with a cast, and you must decide which action performed by the patient’s significant other requires you to re-educate the patient and family about cast care.

This question is one of the many questions we will be practicing in our new series called “Weekly NCLEX Question”.

So, every week be sure to tune into our YouTube Channel for the NCLEX Question of the Week.

More NCLEX Weekly Practice Questions.

NCLEX Cast Care Lecture

NCLEX Cast Care Review Question

Your patient is 2 hours post-op from a cast placement on the right leg. The patient has family in the room. Which action by the significant other requires you to re-educate the patient and family about cast care?

A. Checking the color and temperature of the right foot.

B. Elevating the cast above heart level with pillows.

C. Gently using the fingertips of the hands to move the cast every 2 hours to help with drying.

D. Using a hair dryer on the cool setting to help with drying and itching. ELIMINATED! This can be done to help the cast dry faster and help with itching. The hair dryer should never be on a warm or hot setting due to the risk of burns.

Cast care will help the cast dry and harden correctly, and then protect it until it comes off. Your cast may need up to 48 hours to dry and harden completely. Even after your cast hardens, it can be damaged.

How do I care for my cast while it hardens?

• Protect the cast. Do not put weight on the cast. Do not bend, lean on, or hit the cast with anything. Use the palms of your hands when you move the cast. Do not use your fingers. Your fingers may leave marks on the cast as it dries.
• Change positions often. Change your position every 2 hours to help the cast dry faster. Prop your cast on something soft, such as a pillow, to prevent a flat area on your cast.
• Keep the cast dry. Tie plastic trash bags around your cast to keep it dry while you bathe. You may use a blow dryer on cool or the lowest heat setting to dry your cast if it gets wet. Do not use a high heat setting, because you may burn your skin. Certain casts can get wet. Ask if you have a waterproof cast.

How do I care for my cast after it hardens?

• Check your cast every day. Contact your healthcare provider if you notice any cracks, dents, holes, or flaking on your cast.
• Keep your cast clean and dry. Cover your cast with a towel when you eat. You may have a small piece of cast that can be removed to check on incisions under your cast. Make sure the small piece of cast is kept tightly closed. If your cast gets dirty, use a mild detergent and a damp washcloth to wipe off the outside of your cast. Continue to cover your cast with trash bags to keep it dry while you bathe.
• Care for the edges of your cast. Cover the cast edges to keep them smooth. Use 4 inch pieces of waterproof tape. Place one end of the tape under the inside edge of your cast and fold it over to the outside surface. Overlap tape strips until the edges are completely covered. Change the tape as directed. Do not pull or repair any of the padding from inside the cast. This could cause blisters and sores on the skin under your cast.
• Keep weight off your cast. Do not let anyone push down or lean on your cast. This may cause it to break.
• Do not use sharp objects. Do not use a sharp or pointed object to scratch under your cast. This may cause wounds that can get infected, or you may lose the item inside the cast. If your skin itches, blow cool air under the cast. You may also gently scratch your skin outside the cast with a cloth.

When should I seek immediate care?

• Your cast breaks or gets damaged.
• You see drainage, or your cast is stained or smells bad.
• Your skin turns blue or pale.
• Your skin tingles, burns, or is cold or numb.
• You have severe pain that is getting worse and does not go away after you take pain medicine.
• Your limb swells, or your cast looks or feels tighter than it was before.

When should I contact my healthcare provider?

• Something falls into your cast and gets stuck.
• You have itching, pain, burning, or weakness where you have the cast.
• You have a fever.
• You have sores, blisters, or breaks on the skin around the edges of the cast.
• You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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