cast - report on afpmc

8/7/2019 Cast - Report on Afpmc

1/20

Prepared by: Santiago, Aizelle G.


2/20

BONY POINTS: Always pad these parts of limb, especially if the patient isthin.

A cast will be uncomfortable and pressure sores may form.

TUBULAR STOCKINETTE: thread this over his limb, leaving it long enough toextend several centimetres above and below the cast. If necessary, cut ahole for patients thumb.

NO STOCKINETTE: wind ordinary cotton bandages on to his limb.

ORTHOPEDIC PADDING/COTTON WOOL: Roll this smoothly over his wholelimb, evenly with no folds or lumps, and without obscuring the shape ofthe limb. Dont pull it tight or it will tear. You may need 2 or 3 layers tobuild up a thickness of about 1 cm. Put extra padding over bonyprominences. Apply it from well above to well below where the cast willend.


3/20


4/20

BONY POINTS: Always pad these parts of limb, especially if thepatient is thin.

A cast will be uncomfortable and pressure sores may form.

TUBULAR STOCKINETTE: thread this over his limb, leaving it longenough to extend several centimeters above and below thecast. If necessary, cut a hole for patients thumb.

NO STOCKINETTE: wind ordinary cotton bandages on to his limb.

ORTHOPEDIC PADDING/COTTON WOOL: Roll this smoothly overhis whole limb, evenly with no folds or lumps, and withoutobscuring the shape of the limb. You may need 2 or 3 layersto build up a thickness of about 1 cm. Put extra padding overbony prominences.


5/20


6/20

Soft resilient material such as wool, felt and specialorthopedic padding is placed on the skin before plasterapplication.

Padding serves to:

1. Prevent sores

2. Increase comfort

3. Act as a spacer to aid removal.

Padding is extremely important in following situations:

1. When swelling is present or expected, i.e., in almost everyacute 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


7/20


8/20


9/20


10/20


11/20


12/20

NO!


13/20


14/20


15/20

Explain why you are applying the cast, and when you expectto remove it.

Tell the patient not to use his limb or bear weight on his legfor 48 hours while his cast dries out. Warn him to raise it toprevent swelling, to keep it dry, and to return immediately ifhe haspain, numbness, stiffness, or if his fingers or toesbecome 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.


16/20

A FRACTUREPASSPORT is auseful reminder

to the patient,and yourself,especially if hisnotes are lost.

Record both

the date of hisfracture, thedate the cast isapplied, andthe date it is to

be removed. The best way to

write on adamp cast is touse a blue

indelible pencil.


17/20

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 aplaster cast (heat cannot be used on a plaster castbecause the cast heats up and may burn the skin)

> turn the extremity every once in a while so that allsides 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.


18/20

2. Monitoring a Patient After Casting

* Nursing Interventions> monitor the neurovascular status of the

affected extremity; notify MD if NVcompromise occurs

> instruct the client in isometric exercises toprevent muscle atrophy

> instruct patients not to stick objects insidethe cast

> monitor for warmth / wet spots on the cast

> monitor for foul odor> monitor the clients temperature


19/20

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.


20/20

1. Use a diaper or sanitary napkin around thegenital area to prevent leakage or

splashing of urine.2. Place toilet paper inside the bedpan to

prevent urine from splashing onto the castor bed.

3. Keep the genital area as clean and dry aspossible to prevent skin irritation.

cast - report on afpmc

Documents