Safety and Infection Control Q 6
A client with a fractured tibia has a plaster-of-Paris cast applied to immobilize the fracture. Which action by the nurse indicates an understanding of a plaster-of-Paris cast? The nurse:
A. Handles the cast with the fingertips
B. Petals the cast
C. Dries the cast with a hair dryer
D. Allows 24 hours before bearing weight
Correct Answer: D. Allows 24 hours before bearing weight
A plaster-of-Paris cast takes 24 hours to dry, and the client should not bear weight for 24 hours. After the process of applying the casting material is completed, the material will start to dry in about 10 to 15 minutes. The temperature of the skin might rise as the plaster is drying because of a chemical reaction that occurs. When plaster is used, it can take from 1 to 2 days for the cast to harden completely.
Option A: The cast should be handled with the palms, not the fingertips. Use the palm of hand to apply, hold, or move cast and support on pillows after application. Uneven plaster is irritating to the skin and may result in abrasions.
Option B: Petaling a cast is covering the end of the cast with cast batting or a sock, to prevent skin irritation and flaking of the skin under the cast. Trim excess plaster from edges of the cast as soon as casting is completed; prevents skin breakdown caused by prolonged moisture trapped under the cast.
Option C: The client should be told not to dry the cast with a hair dryer because this causes hot spots and could burn the client. This also causes unequal drying. Promote cast drying by removing bed linen, exposing it to circulating air; pressure can cause ulcerations, necrosis, or nerve palsies. Pad (petal) the edges of the cast with waterproof tape; provides an effective barrier to cast flaking and moisture. Helps prevent the breakdown of cast material at the edges and reduce skin irritation and excoriation.