Nursing Cast Care NCLEX Practice Question for Fractures

Nursing cast care NCLEX review question on how to care for a patient with a bone fracture.

This NCLEX practice question will test your nursing knowledge on how to properly care for a new cast placed after a bone fracture. To answer this question correctly, you must know the complications associated with casts placement (compartment syndrome), how to prevent swelling, monitoring the neurovascular status (6 P's), how to promote even drying, etc.

Why are casts placed after a bone fracture? To help with immobilizing the fracture to help promote the natural healing process. A cast is usually placed after a closed bone reduction, which is where the bone is manually put back into its original state. There are various types of casts, such as plaster or fiberglass.

Nursing Interventions for a Cast:
-Monitor for compartment syndrome: 6 P’s
-Monitor for infection: hotspots in the case, severe pain, fever
-Keep the cast and extremity elevated above the heart level (decreases swelling).
-Apply ice packs to the case for the first 2 days to decrease swelling.
-Turn the cast every 2 hours to promote even drying.
-Use palms of hands to handle (not fingertips) when new with wet plaster:
WHY? Prevents dent formation in cast by handling with the palms of hand. These dents can cause ulcer formation overtime.
-Maintain skin integrity: petal the cast and apply a soft tape called moleskin around the edge to prevent skin breakdown.
-Keep cast dry and never stick anything inside it to itch a scratch.

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