1. Name the uses of a cast
    • •A rigid, external immobilizing
    • device
    • Uses: Immobilize a reduced fracture
    •          Correct deformity 
    •          Uniform pressure on soft tissue
    •          Support or stabilize
    • Materials: Nonplaster (fiber glass) & plaster
  2. Short arm, Long arm, Short leg, Long leg, Body, Shoulder spica, Hip spica
    • Short arm: Below the elbow to palmer crease
    • Long arm:axillary fold to palmer crease
    • Short Leg: Knee to base of toes
    • Long leg: Upper and middle third of thigh to base of toes
    • Shoulder spica pica: A body jacket that encloses the trunk shoulder and elbow
    • Hip Spica: Trunk and lower extremities
  3. Education Needs of the Patient With a Cast
    •Before cast application

    –Explanation of condition necessitating the cast

    –Purpose and goals of the cast

    –Expectations during the casting process (e.g., heat from hardening plaster)

    •Cast care: keep dry; do not cover with plastic

    •Positioning: elevation of extremity, use of slings


    •Activity and mobility


    • •Do not scratch or stick anything
    • under cast

    •Cushion rough edges

    • •Signs and symptoms to report:
    • persistent pain or swelling, changes in sensation, movement, skin color or
    • temperature, signs of infection or pressure areas

    •Required follow-up care

    •Cast removal
  4. Splints and Braces
    • •Contoured splints of plaster or
    • pliable thermoplastic materials may be used for conditions that do not require
    • rigid immobilization, for those in which swelling may be anticipated, and for
    • those who require special skin care.

    • •Braces (i.e., orthoses) are used to
    • provide support, control movement, and prevent additional injury. They are
    • custom fitted to various parts of the body.
  5. Brace, Splint, or Cast Collaborative Problems and Potential Complications
    • •Compartment syndrome
    •    Note: Unrelieved pain may indicate
    • compartment syndrome; discomfort caused by pressure may require change of cast

    •Pressure ulcer

    •Disuse syndrome

    • •Delayed union or nonunion of
    • fracture(s)
  6. External Fixation Devices
    •Used to manage open fractures

    •Provide support

    •Patient requires reassurance

    • •Discomfort is usually minimal, and
    • early mobility may be anticipated with these devices.

    •Elevate -

    • •Monitor for signs and symptoms of
    • complications, including infection

    •Pin care

    •Patient education
  7. Traction
    • ⇛The application of pulling force to a part of the body. The lines of pull are "vector of forces"
    • Purpose:
    • Dec. spasm
    • Realignment of bone fractures
    • Preventing deformities
    • inc. space btw opposing forces
  8. Uses for buck's extension traction and halo brace
    • Busk's- For fractured hip
    • Halo-cervical fracture
  9. Principles of Effective Traction
    •Whenever traction is applied, a counterforce must be applied. Frequently, the patient’s body weight and positioning in bed supply the counterforce.

    •Traction must be continuous to reduce and immobilize fractures.

    •Skeletal traction is never interrupted.

    •Weights are not removed unless intermittent traction is prescribed.

    •Any factor that reduces pull must be eliminated.

    •Ropes must be unobstructed, and weights must hang freely.

    •Knots or the footplate must not touch the foot of the bed.
  10. Nursing Process: The Care of the Patient in Traction—Assessment
    • •Assessment of neurovascular status
    • and for complications

    • •Assessment for mobility-related
    • complications of pneumonia, atelectasis, constipation, nutritional problems,
    • urinary stasis, or UTI

    •Pain and discomfort

    •Emotional and behavioral responses


    •Thought processes

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