A child is brought to the emergency department, and a fracture of the left lower arm is suspected. The mother states that the child was rollerblading and attempted to break a fall with an outstretched arm

Question

Diagnostic x-rays of the child reveal that a fracture is present. A plaster of Paris cast is applied to the arm, and the nurse provides instructions to the mother regarding cast care at home. Which teaching points would the nurse provide the mother? Select all that apply. 1. The cast should be dry in about 6 hours.
2. The cast is water-resistant, so the child is able to take a bath or a shower.
3. The cast will mold to the body part.
4. The cast needs to be kept dry, because when wet it will begin to disintegrate.
5. Keep the cast elevated for the first day on pillows.
6. Make sure that the child can frequently wiggle the fingers.

Answer 1

3, 4, 5, 6

Rationale: "The cast will mold to the body part," "the cast needs to be kept dry, because when wet it will begin to disintegrate," "keep the cast elevated for the first day on pillows," and "make sure that the child can frequently wiggle the fingers" are all important components of a teaching plan for a parent. Plaster of Paris is a heavier material than that used in a synthetic cast. It molds easily to the extremity and is less expensive than a synthetic cast. It takes about 24 hours to dry, but drying time could be longer, depending on the size of the cast. Plaster of Paris is not wa-ter-resistant and, when wet, will begin to disintegrate. The cast should be elevated on a pillow for the first day to decrease swelling as the cast begins to mold to the arm. As the cast molds, it is imperative that the child can wiggle the fingers, because the extremity continues to swell. If the child can wiggle the fingers, adequate motion is present. Color and sensation of the fingers should also be assessed.