The patient tells the nurse that the top of the plaster cast feels rough and is scratching the skin. Which intervention should the nurse implement?

Question

a. Explain that this is an expected outcome.
b. Trim away sharp areas and edge with tape.
c. Medicate the patient with a prescribed analgesic.
d. Speak with the healthcare provider about a cast change.

Answer 1

B
All plaster casts have rough edges before they are "finished," and the nurse finishes the edge to prevent skin breakdown and infection. To finish the cast, the nurse carefully trims away the thin, uneven edge and reinforces the edge with tape. If the cast is finished with stockinette, the healthcare provider folds the stockinette over the edge of the cast and makes a final loop with the casting material around the cast to hold the stockinette in place. Pain medication can become necessary; however, the priority is to prevent skin breakdown and infection. The discomfort will resolve after the edge is finished and edema subsides. A cast change is not indicated.