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Cast - Report on Afpmc

Cast - Report on Afpmc

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Published by: Gillarhymes on Apr 19, 2011
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04/19/2011

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Prepared by: Santiago, Aizelle G.

BONY POINTS: Always pad these parts of limb, especially if the patient is thin. ® A cast will be uncomfortable and pressure sores may form. TUBULAR STOCKINETTE: thread this over his limb, leaving it long enough to extend several centimetres above and below the cast. If necessary, cut a hole for patient s thumb. NO STOCKINETTE: wind ordinary cotton bandages on to his limb. ORTHOPEDIC PADDING/COTTON WOOL: Roll this smoothly over his whole limb, evenly with no folds or lumps, and without obscuring the shape of the limb. Don t pull it tight or it will tear. You may need 2 or 3 layers to build up a thickness of about 1 cm. Put extra padding over bony prominences. Apply it from well above to well below where the cast will end.

BONY POINTS: Always pad these parts of limb, especially if the patient is thin. ® A cast will be uncomfortable and pressure sores may form. TUBULAR STOCKINETTE: thread this over his limb, leaving it long enough to extend several centimeters above and below the cast. If necessary, cut a hole for patient s thumb. NO STOCKINETTE: wind ordinary cotton bandages on to his limb. ORTHOPEDIC PADDING/COTTON WOOL: Roll this smoothly over his whole limb, evenly with no folds or lumps, and without obscuring the shape of the limb. You may need 2 or 3 layers to build up a thickness of about 1 cm. Put extra padding over bony prominences.

Soft resilient material such as wool, felt and special orthopedic padding is placed on the skin before plaster application. Padding serves to: 1. Prevent sores 2. Increase comfort 3. Act as a ³spacer´ to aid removal. Padding is extremely important in following situations: 1. When swelling is present or expected, i.e., in almost every acute condition 2. When limb is thin and bones are very superficial 3. When the electric plaster cutters are used for removal 4. When wedging is contemplated

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Explain why you are applying the cast, and when you expect to remove it. Tell the patient not to use his limb or bear weight on his leg for 48 hours while his cast dries out. Warn him to raise it to prevent swelling, to keep it dry, and to return immediately if he has pain, numbness, stiffness, or if his fingers or toes become cold, blue, or swollen. He must also return if his cast becomes loose. Explain that he must exercise his muscles inside the cast, and the joints which are not immobilized, especially his fingers and toes.

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A FRACTURE PASSPORT is a useful reminder to the patient, and yourself, especially if his notes are lost. Record both the date of his fracture, the date the cast is applied, and the date it is to be removed. The best way to write on a damp cast is to use a blue indelible pencil.

1. Assisting With the Application of a POP Cast * Nursing Interventions: > handle a wet cast only with the palm of your hands > cool settings on a hair dryer can be used to dry a plaster cast (heat cannot be used on a plaster cast because the cast heats up and may burn the skin) > turn the extremity every once in a while so that all sides of the cast will dry > examine the cast for possible pressure areas > keep the cast and extremity elevated > POP casts need 24 to 48 hrs. to dry / fiberglass casts 20 to 30 min.

2. Monitoring a Patient After Casting * Nursing Interventions > monitor the neurovascular status of the affected extremity; notify MD if NV compromise occurs > instruct the client in isometric exercises to prevent muscle atrophy > instruct patients not to stick objects inside the cast > monitor for warmth / wet spots on the cast > monitor for foul odor > monitor the client s temperature

3. Cast care instructions:
> Keep the cast clean and dry. > Elevate the cast above the level of the heart to decrease swelling. > Encourage patient to move his/her fingers or toes to promote circulation. > Check for cracks or breaks in the cast. - Rough edges can be padded to protect the skin from scratches. > Do not scratch the skin under the cast by inserting objects inside the cast. - Can use a hairdryer placed on a cool setting to blow air under the cast and cool down the hot, itchy skin. Never blow warm or hot air into the cast. - Do not put powders or lotion inside the cast. > Cover the cast while patient is eating to prevent food spills and crumbs from entering the cast.

1. Use a diaper or sanitary napkin around the genital area to prevent leakage or splashing of urine. 2. Place toilet paper inside the bedpan to prevent urine from splashing onto the cast or bed. 3. Keep the genital area as clean and dry as possible to prevent skin irritation.

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