Question

June Frankel, a 23-year-old patient, presents to the emergency department with a sports-related fracture injury to her right arm and receives a long-arm fiberglass cast. What nursing assessment should the nurse provide after the cast has been applied? What nursing interventions should the nurse provide?

Answer 1

What nursing assessment should the nurse provide after the cast has been applied?

1. Assess the neuro vascular compromise like pain, pallor, paresthesia, paralysis etc.(ii) Asses for swellings
2. Make sure the plaster cast is dry
3. Assess for bluish or whitish discoloration of the fingers
4. Check peripheral pulse
5. Assess for neurovascular status and for potential complication like signs and symptoms of infection.
6. Assess for hot and wet spots on or near the casted area

What nursing interventions should the nurse provide?

1. Assess vital signs, incision site and portable suction drainage device, neurovascular checks on right hip and leg, and pain assessment as ordered
2. Use fracture pan and instruct the patient to flex the left leg and hip and use the trapeze bar to get onto the bedpan or to get off the bedpan and not to place pressure or flex the right knee and hip in the process
3. Keep a draw sheet under the patient from head to feet to use in turning or moving the patient up in the bed, and utilize the assistance of two medical caretakers
4. Instruct the patient to perform practices that the physical advisor endorsed to counteract contractures and to advance versatility
5. Provide thromboembolism-avoidance measures, including the use of endorsed enemy of embolism hose, successive pressure boots, and low atomic weight heparin, for example, enoxaparin (Lovenox)
6. Instruct the patient to use the incentive spirometer, cough and deep breathe every two hours while awake. Report any change in the coloration of sputum and signs of respiratory infection immediately to the physician.
7. Promote early ambulation as ordered:
8. Monitor for orthostatic hypotension.
9. Transfer to remaining with walker per physical advisor convention as requested by specialist.
10. Ambulate to seat utilizing the walker by propelling the walker, at that point the worked furthest point, and afterward the nonoperated limit. (Pursue weight-bearing confinements).
11. When sitting in the seat, don't sit for longer than 30 minutes. Flex the hip under 90 degrees.
12. When sitting, keep the knees separated and don't fold the legs.
13. Avoid bending forward while sitting in a chair.
14. Do not flex the hip when putting on clothing articles. Use a long-handled reaching device to help dress.
15. Use elevated seat cushion in the chair and a raised toilet seat to help prevent over flexion of the hip joint.

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