A client is discharged to home after application of a plaster leg cast. The nurse determines that the client understands proper care of the cast if the client states that he should?

Appeared in: PGIMER Chandigarh NO - 2015

Explanation

A new plaster cast remains soft and malleable for 24-48 hours until it is fully dry.
Handling a wet cast with the palms of the hands distributes pressure over a wide surface area, which is the correct and safe technique.
This method prevents the formation of dents or indentations in the soft plaster.
Indentations can create pressure points on the skin underneath, leading to complications like pressure ulcers and compromised circulation.

Option B: Inserting any object under the cast, even if padded, can break the skin and introduce bacteria, leading to a serious infection that is hidden from view.
Option C: A drying plaster cast releases heat (an exothermic reaction). Covering it traps this heat, which can cause burns, and also traps moisture, which prevents the cast from drying properly and can weaken it.
Option D: Using fingertips concentrates pressure on small areas of the wet cast, creating indentations that can lead to pressure ulcers on the skin below.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Patient education and safety principles for plaster cast care in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Effective patient education is a critical nursing responsibility to prevent serious complications like pressure ulcers, infections, and compartment syndrome.
Nurses must emphasize that complications under a cast are hidden from sight, so prevention and reporting early warning signs (e.g., foul odor, hot spots, increased pain) are paramount for patient safety.
What if? If the cast were made of fiberglass instead of plaster, it would be more durable and dry much faster (within an hour). While careful handling is still good practice, the risk of indentation from fingertips is significantly lower. The focus of teaching would shift more towards keeping it dry and monitoring neurovascular status.

How to Approach the Question

First, identify the core subject of the question: proper care for a newly applied plaster cast.
Recall the key principles of plaster cast care, focusing on the initial drying period (24-48 hours) when the cast is most vulnerable.
Evaluate each option based on safety and standard nursing procedures.
Option A (using palms) distributes pressure and is the recommended technique.
Option B (scratching with an object) risks skin integrity and is contraindicated.
Option C (covering the cast) hinders drying, traps heat, and is contraindicated.

Concept Tested & Keywords

Concept Tested: Patient education and safety principles for plaster cast care.
Stem keywords: plaster leg cast, discharged, proper care, understands
Lead-in keywords: understands
Clinical cues: The care setting changes urgency, monitoring level, and the expected nursing action.

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 pp. 122-124, 119-121

Practise the full PGIMER Chandigarh NO - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.