Orthopedic Immobilization Devices in Nursing
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Questions and Answers

What is the likely indication of unrelieved pain or pain out of proportion following cast application?

  • Complications (correct)
  • Edema relief
  • Systemic infection
  • Proper cast immobilization
  • What is the purpose of petalling and windowing in cast care?

  • To relieve pain associated with underlying conditions
  • To monitor for signs of systemic infection
  • To smooth out rough edges and resolve skin irritation (correct)
  • To facilitate joint movement
  • What is the primary goal when managing suspected cases of acute compartment syndrome?

  • Split the cast into two and position the affected limb at the level of the heart (correct)
  • Administer pain relief medication
  • Apply ice packs to the affected area
  • Elevate the affected limb
  • What is the common cause of acute compartment syndrome in tibial fracture patients?

    <p>Postoperative hematoma</p> Signup and view all the answers

    What is the consequence of increased pressure within a confined space, such as a cast?

    <p>Compromised blood flow and tissue perfusion</p> Signup and view all the answers

    Why is it important to observe for signs of systemic infection in cast care?

    <p>To identify potential complications that may arise</p> Signup and view all the answers

    What is the purpose of bi-valving in acute compartment syndrome management?

    <p>To split the cast into two</p> Signup and view all the answers

    What is the benefit of elevating the affected limb in cast care?

    <p>Controls pain due to edema</p> Signup and view all the answers

    What is the consequence of immobilizing a joint that is not affected by the cast?

    <p>Facilitated movement and exercise</p> Signup and view all the answers

    Why is it important to position the affected limb at the level of the heart in acute compartment syndrome management?

    <p>To improve tissue perfusion</p> Signup and view all the answers

    Study Notes

    Cast and Cast Care

    • A cast is a rigid external device molded to the body's contours for immobilization.
    • Purposes: immobilize fractures, correct/deformities, apply pressure to tissues, and stabilize joints.

    Types of Casts

    • Short-arm Cast: Extends from below the elbow to the palmar crease.
    • Short-arm Thumb Spica Cast: Similar to short-arm cast but includes the thumb.
    • Long-arm Cast: Extends from the axillary fold to proximal palmar crease, immobilizing elbow at a right angle.
    • Short-leg Cast: Extends from below the knee to the base of the toes with foot in neutral position.
    • Long-leg Cast: Extends from upper thigh to the toes, with slight knee flexion.
    • Walking Cast: A reinforced short or long leg cast for mobility.
    • Shoulder Spica Cast: For shoulder dislocations, encircles trunk, shoulder, and arm.
    • Unilateral Hip Spica Cast: For thigh fractures, extends from the chest to the affected foot.
    • One-and-one-half Hip Spica Cast: Similar to unilateral but includes bar for immobility of both legs.
    • Bilateral Hip Spica Cast: For pelvis or thigh fractures; can be short or long leg.

    Cast Materials

    • Plaster of Paris: Requires clean, room temperature water; molds well, but is heavy and non-water-resistant. Takes 24-72 hours to dry.
      • Wet plaster: damp, dull gray, musty smell.
      • Dry plaster: hard, shiny white, resonant, and odorless.
    • Fiberglass: Non-absorbent, tepid water for activation; waterproof and dries in 30 minutes, but harder to mold.
      • Facilitates radiographic imaging better than plaster.
      • Inform patients about the warmth sensation during application.

    Nursing Responsibilities for Cast Application

    • Pre-Procedure:
      • Conduct baseline assessments (skin, neurovascular status).
      • Provide necessary wound care and administer tetanus shots if indicated.
      • Orient patient/family on the purpose and expectations of cast.
    • Post-Procedure:
      • Monitor the immobilized area for the 6 Ps: Pain, Paresthesia, Pulselessness, Pallor, Poikilothermia, Paralysis.
      • Elevate extremity at heart level to enhance perfusion and prevent edema.
      • Evaluate pain characteristics: differentiate between pain relief from immobilization and pain from edema.
      • Watch for systemic infection signs like odor or discharge.

    Cast Care Techniques

    • Petalling: Smoothing rough cast edges with adhesive tapes to prevent irritation.
    • Windowing: Removing a part of the cast for observation or to assess pulse.

    Acute Compartment Syndrome

    • Occurs due to increased internal pressure that compromises blood flow.
    • Common causes include tight casts, burns, infiltrated IVs, or postoperative hematomas.
    • Management involves:
      • Bi-valving: splitting the cast.
      • Position limb at heart level, avoiding elevation to maintain arterial flow.

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    Description

    This quiz covers the purposes and types of orthopedic immobilization devices, including casts, used in nursing care. It explores their application in fracture immobilization, deformity correction, and joint stabilization.

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