Casts and Immobilization methods

Question 1

Fiberglass Casts

Answer 1

1. Lightweight
2. Relatively waterproof
3. Support immediate mobilization

Question 2

Plaster of Paris Casts

Answer 2

1. Used when cast changes are anticipated
2. Can take 72 hours to fully dry
3. Will generate heat during the drying period and requires close monitoring of neurovascular status which includes the 6 Ps

Question 3

Thermoplastic Casts

Answer 3

Plastic type resins that are heated and molded to the body

Question 4

Cast Care Instructions

Answer 4

1. Do not get cast wet unless OK with Md
2. Keep the extremity elevated as directed by MD
3. Do not put anything in the cast, doing so could cause injury or infection
4. Check circulation of extremity by feeling fingers and toes for warmth and pink color
5. Pain which is not relieved by elevation and 1-2 doses of pain medication should be reported to the MD
6. Fever, drainage, foul odor from cast should be reported to the MD
7. Check the cast daily for cracks. check the skin around cast for irritation or redness

Question 5

Fracture Immobilization Using External Fixators

Answer 5

1. Device that maintains alignment of bone fragments through the use of wires or pins that are attached directly to the bone and held in anatomical alignment by external rods
2. Often used to salvage complex, mangled extremity fractures that otherwise might be amputated at the time of the injury
3. Long Term Process
4. Assess for pin loosening and infection

Question 6

Fracture Immobilization Using Internal Fixation

Answer 6

1. Devices include pins, plates, screws, or road that are placed through surgical incision in order to maintain alignment of the bone fragments
2. Requires pre and post operative care of the client undergoing a fixation of a fracture
3. May require additional orthopedic devices such as splints, slings to provide support to the operative site

Question 7

Fracture Immboliziation Using Traction

Answer 7

1. Continous pulling force that can be directly applied to the bone through the use of pins or to the skin with the use of special splints
2. Pulling forces maintain alignment of the fractured bones through traction and counter-traction pulling forces
3. Pulling force is acheived by counterweights
4. Two types: Skin and Skeletal

Question 8

Skin Traction

Answer 8

1. Use of weights to align fraction or dislocated joint using tape, straps, or boots
2. Short term use
3. Pre-op use
4. 5-7 pounds of weight used with skin traction
5. TYPES:
   
   1. Buck’s
   2. Russell’s
   3. Bryant’s
   4. Pelvic

Question 9

Skeletal Traction

Answer 9

1. Pins, screws, wires are surgically inserted into bone and then attached to weights to provide traction
2. Heavier weights can be used with skeletal traction
3. Both short term or long term
4. Pre op or as treatment for the fracture if patient is unable to tolerate surgery

Question 10

NUR assessment for a client in traction

Answer 10

1. Pain
2. Neurovascular status and skin temperature
3. Skin integrity over bony prominences for pressure necrosis
4. Correct angle of pull of traction and counter traction forces
5. Correct weight for traction
6. External rotation of hip or foot drop prevention
7. Prevention of skin infection at pin sites

Question 11

T-R-A-C-T-I-O-N

Answer 11

Temperature of extremity/infection

Ropes hang freely

Alignment

Circulation

Type and location of fracture

Increase fluid intake (DVT, constipation)

Overhead trapez

No weights on floor or bed