29 Questions
What is the primary purpose of a cast?
To immobilize a reduced fracture
Which type of cast extends from the axillary fold to the proximal palmar crease?
Long-arm cast
What is the primary difference between a short-arm cast and a short-arm thumb spica cast?
Inclusion of the thumb
Which type of cast is reinforced for strength to allow walking?
Walking cast
What is the position of the foot in a short-leg cast?
Flexed at a right angle
What is the purpose of bi-valving or splitting a cast?
To release pressure from the cast
What is the primary goal of early diagnosis of compartment syndrome?
To prevent tissue damage
Why is it essential to delay wound closure after emergency fasciotomy?
To allow edema to subside
What is the primary role of the nurse in post-operative care?
To monitor pain control status
What is the primary benefit of emergency fasciotomy?
To reduce tissue damage
Why is it crucial to diagnose compartment syndrome early?
To prevent irreversible tissue damage
What is the primary purpose of using assistive devices such as crutches in patient care?
To promote independence in ambulation
What is the purpose of countertraction in patient care?
To create an opposing force to traction
Why is it essential to ensure the patient is in good body alignment when applying traction?
To ensure the effective pull of traction
What is the purpose of skeletal traction?
To correct or prevent deformities
What is the primary principle of effective traction?
Traction must be continuous to be effective
What type of traction is applied in a straight line with the body part resting on the bed?
Straight (Running) Traction
What type of cast is used for shoulder dislocations or after surgery on the shoulder area?
Shoulder Spica Cast
What is the main difference between a Unilateral Hip Spica Cast and a One-and-one-half Hip Spica Cast?
The Unilateral Hip Spica Cast is applied to one leg, while the One-and-one-half Hip Spica Cast is applied to both legs but only up to the knee.
What is the advantage of using plaster of Paris as a cast material?
It achieves a better mold than fiberglass.
What is a characteristic of a wet plaster cast?
It feels damp, appears dull and gray, and sounds dull on percussion.
What is a difference between a Bilateral Hip Spica Cast and a Unilateral Hip Spica Cast?
A Bilateral Hip Spica Cast is applied to both legs, while a Unilateral Hip Spica Cast is applied to one leg.
How long does it take for a plaster of Paris cast to dry?
Up to 24 to 72 hours
What is the primary function of countertraction in Balanced Suspension Traction?
To counter the pulling force of the traction
What is the main advantage of Russel Traction?
It allows patient to move about in bed more freely
In Bryant's Traction, why are both legs raised at a 90-degree angle to the bed?
Because the weight of the child might not be enough to provide countertraction
What is the purpose of flexing the hips at 20-30 degrees in Russel Traction?
To provide countertraction
What is the recommended practice for pin site care in the first 48 hours?
Covering the pin site with a sterile absorbent nonstick dressing and rolled gauze
What is the purpose of the footplate in Thomas Splint with Pearson Attachment?
To prevent foot drop
Study Notes
Acute Compartment Syndrome Management
- Immobilize the leg with the ankle in slight plantar flexion
- Release pressure from the cast using bi-valving or splitting
- Administer analgesics as ordered
- Institute renal protective measures, such as isotonic fluid infusion for hypovolemia and NaHCO3 to alkalinize urine
- Administer mannitol IV if urine output is less than 300mL/hr
Emergency Fasciotomy
- Surgical incision of the fascia is the only effective way to treat acute compartment syndrome
- Early diagnosis of compartment syndrome is crucial, as tissue damage becomes irreversible 4 to 6 hours after increased compartment pressure
- Delayed closure of the wound 3-5 days after to allow edema to subside
Post-Operative Activity
- Limit weight bearing immediately post-op, requiring the use of assistive devices such as crutches
- Instruct and reinforce safe crutch walking
- Monitor pain control status and facilitate pain management as needed
- Coordinate with physical therapist for ROM and flexibility exercises
Casts and Cast Care
- A cast is a rigid external immobilizing device molded to the contours of the body
- Purposes of a cast: immobilization, correction or prevention of deformity, and application of uniform pressure to underlying soft tissue
- Types of casts: short-arm, short-arm thumb spica, long-arm, short-leg, long-leg, walking cast, and bilateral hip spica cast
Traction
- Traction uses a pulling force to promote and maintain alignment to an injured part of the body
- Purposes of traction: decrease muscle spasms and pain, realign bone fractures, and correct or prevent deformities
- Types of traction: skin traction, skeletal traction, straight (running) traction, and balanced suspension traction
- Principles of effective traction: continuous traction, good body alignment, unobstructed ropes, and freely hanging weights
Cast Materials
- Plaster of Paris: requires clean, room temperature water during application, achieves a better mold than fiberglass, but is heavy and not water-resistant, and takes up to 24 to 72 hours to dry
Test your knowledge on casts, a rigid external immobilizing device used to immobilize fractures, correct deformities, and support weakened joints. Learn about different types of casts, including short-arm and long-arm casts.
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