The nurse is caring for a client with a cast on the left leg. The nurse would be MOST concerned if which of the following is observed?
1. Capillary refill time is less than 3 seconds
2. Client complains of discomfort and itching
3. Client complains of tightness and pain
4. Client’s foot is elevated on a pillow
Casts
Description:
Plaster or fiberglass casts are used to immobilize bones and joints into correct alignment after a fracture or injury.
Interventions
Keep the cast and extremity elevated.
Allow a wet plaster cast 24 to 72 hours to dry (synthetic casts dry in 20 minutes).
Handle a wet plaster cast with the palms of the hands until dry.
Turn the extremity every 1 to 2 hours, unless contraindicated, to allow air circulation and promote drying of the cast.
Ahair dryer canbe usedon a cool setting todry a plaster cast (heat cannot beusedonaplaster cast because the cast heats up and burns the skin).
Prepare for bivalving or cutting the cast if circulatory impairment occurs.
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.
Monitor for signs of infection such as increased temperature, hot spots on the cast, foul odor, or changes in pain.
If an open draining area exists on the affected extremity, the physician will make a cutout portion of the cast known as a window.
Instruct the client not to stick objects inside the cast.
Teach the client to keep the cast clean and dry.
Instruct the client in isometric exercises to prevent muscle atrophy.