Ateneo de Zamboanga University COLLEGE OF NURSING NURSING SKILLS OUTPUT

Report No. 4

CARE FOR CAST

I.

DESCRIPTION:

Cast is a hard covering the doctor puts over your leg/arm to keep the broken bone in place so it can heal properly. The function of a cast is to rigidly protect an injured bone or joint. It serves to hold the broken bone in proper alignment to prevent it from moving while it heals.

II.

MATERIALS/ EQUIPMENTS NEEDED:

Adhesive tape (to prevent slippage of elastic wrap used with splints) Bandage scissors Basin of water at room temperature (dipping water) Casting gloves (necessary for fiberglass) Elastic bandage (for splints) Padding Plaster or fiberglass casting material Sheets, underpads (to minimize soiling of the patient's clothing) Stockinette

III.

PROCEDURE:

Many different sizes and shapes of casts are available depending on what body part needs to be protected. A doctor decides which type and shape is best for each person. Cast application a) Before casting material is applied (plaster or fiberglass), a "stockinette" is usually placed on the skin where the cast begins and ends(at the hand and near the elbow for a wrist cast). This stockinette protects the skin from the casting material. b) After the stockinette is placed, soft cotton batting material (also called cast padding or Webril) is rolled on. This cotton batting layer provides both additional padding to protect the skin and elastic pressure to the fracture to aid in healing. c) Next, the plaster or fiberglass cast material is rolled on while it is still wet. d) The cast will usually begin to feel hard about 10-15 minutes after it is put on, but it takes much longer to be fully dry and hard.

e) Be especially careful with the cast for the first 1-2 days because it can easily crack or break while it is drying and hardening. It cantake up to 24-48 hours for the cast to completely harden. Plaster casts a) A plaster cast is made from rolls or pieces of dry muslin that have starch or dextrose and calcium sulfate added. b) When the plaster gets wet, a chemical reaction happens (between the water and the calcium sulfate) that produces heat andeventually causes the plaster to set, or get hard, when it dries. c) A person can usually feel the cast getting warm on the skin from this chemical reaction as it sets. d) The temperature of the water used to wet the plaster affects the rate at which the cast sets. When colder water is used, it takeslonger for the plaster to set, and a smaller amount of heat is produced from the chemical reaction. Plaster casts are usually smooth and white. Fiberglass casts Fiberglass casts are also applied starting from a roll that gets wet. a) After the roll gets wet, it is rolled on to form the cast. Fiberglass casts also get warm and harden as they dry. Fiberglass casts are rough on the outside and look like a weave when they dry. Some fiberglass casts may even be colored.

IV.

DIAGRAM/ ILLUSTRATIONS

V. NURSING RESPONSIBLITIES 1. Checks for the doctors order. 2. Explain the procedure to the client. Explain to the patient and his or her relative to need for placing the affected part of the body in a cast. 3. Skin preparation. 4. Padding is applied first: either stokinette, web-roll or padding. Make sure that it is fits smoothly, without wrinkles which may cause abrade skin and lead to skin breakdown 5. Plaster-filled bandages are submerged in a bucket of clean water, one at a time. The excess water is removed, and the bandage is applied to encircle the part.

6. During application, support the extremity from underneath using the palms of the hands in such a way that pressure is not applied in one area only. REFERENCES: http://www.scribd.com/doc/2191737/CAST-CARE http://www.aafp.org/afp/2009/0101/p16.html

NOVEMBER 29, 2013 DATE

MS. FLORIBEL SAN LUIS, RN MN CLINICAL INSTRUCTOR MICHELLE ERIKA F. MEJIA BSN III- B