A patient with a below-knee plaster cast reports that the cast has become wet. What is the most appropriate nursing action?

Appeared in: NORCET 10 Prelims-2026

Explanation

A wet plaster cast loses its structural integrity and can no longer properly immobilize the fracture, potentially leading to malunion.
Moisture trapped under the cast creates a breeding ground for bacteria and fungi, increasing the risk of skin maceration, irritation, and infection.
Using a hairdryer on a cool setting is the recommended and safest method to evaporate moisture from a slightly damp cast.
The cool airflow helps dry the plaster material and the underlying padding without applying direct heat, which could cause severe thermal burns to the skin.

Option A: Sunlight is an unreliable and uncontrolled method for drying a cast. It may not penetrate deep enough to dry the inner layers, leaving residual moisture against the skin.
Option C: Ignoring a wet cast is considered negligent. It compromises the cast's function and places the patient at significant risk for complications like skin breakdown, infection, and improper fracture healing.
Option D: Applying any form of direct heat, such as a heating pad, is extremely dangerous. The cast material traps heat, which can quickly lead to severe, deep thermal burns on the skin underneath.

Clinical Relevance

Nursing practice connection: Use the key finding related to Nursing management of a wet plaster cast to guide bedside assessment, documentation, and the next nursing action.
Patient education is a primary nursing responsibility. Clearly instructing patients on cast care, especially the dangers of getting it wet and applying heat, is crucial for preventing complications and ensuring a positive outcome.
A compromised cast can lead to loss of fracture reduction (misalignment), which may require re-manipulation and re-casting, prolonging the patient's recovery and increasing healthcare costs.
What if? - If the cast were made of fiberglass instead of plaster, it would be more water-resistant. However, the padding underneath can still get wet. The advice would be similar—use a cool hairdryer to dry it thoroughly—but the urgency is slightly less as the fiberglass shell itself won't disintegrate.

How to Approach the Question

First, identify the key elements of the clinical scenario: a patient with a plaster cast that is now wet.
Recall the fundamental properties of plaster of Paris: it is not water-resistant and loses its strength and shape when wet.
Consider the primary risks associated with a wet cast: loss of immobilization and skin complications (maceration, infection).
Evaluate each option based on the principles of patient safety and effectiveness.
Rule out any option involving heat (heating pads, hot air) due to the high risk of thermal burns under the cast.
Eliminate passive or ineffective actions ('do nothing', 'sunlight') as they fail to address the risks.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 122-124

Practise the full NORCET 10 Prelims-2026

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