REMAR V2- #6 (Orthopedics)
Canes
• The cane moves with the bad leg, then the good leg follows
When handling a cast during the first 24 hours what part of our hand should we
use?
Palm
Cast Handling:
• Use palms of our hands to handle during the first 24 hours
• Do not use finger tips – Indentation marks may cause skin ulcers
• Do not get the cast wet
How do you relieve itching underneath a cast?
• Use a blow dryer on a cool setting
• Always remember to do neurovascular checks on your client that has a cast on
Compartment Syndrome
• Acute condition: injury caused when tissues such as blood vessels and nerves are
constricted within a space due to swelling or tight dressing/cast
Assess for the 6 P's:
• Pain
• Pallor – paleness
• Paresthesia – loss of sensation
, • Pulselessness – lack of pulse via palpation/auscultation
o Check distal pulses where the cast is located
• Paralysis – temporary/permanent loss of motor control
• Poikilothermia – affected limb cooler than unaffected limb
Nursing Interventions for Compartment Syndrome:
• Cast or restricted bandages must be removed immediately
• Perform neurovascular checks (6 P’s)
• Keep extremity AT HEART LEVEL (not below)
Fasciotomy
• A surgical incision through the fascia to relieve tension/pressure
Why is urine input important to monitor with compartment syndrome?
• Damaged muscle cells will be excreted in the urine (protein in the urine)
Rhabdomyolysis
• Breakdown of skeletal muscle due to injury
• Can lead to kidney damage if not treated
Crutches
• Assist weak/injured patients with walking
• Top of crutches: 2 inches below armpits
• Handgrips: even with the hips
Gaits (walking styles with crutches):
Canes
• The cane moves with the bad leg, then the good leg follows
When handling a cast during the first 24 hours what part of our hand should we
use?
Palm
Cast Handling:
• Use palms of our hands to handle during the first 24 hours
• Do not use finger tips – Indentation marks may cause skin ulcers
• Do not get the cast wet
How do you relieve itching underneath a cast?
• Use a blow dryer on a cool setting
• Always remember to do neurovascular checks on your client that has a cast on
Compartment Syndrome
• Acute condition: injury caused when tissues such as blood vessels and nerves are
constricted within a space due to swelling or tight dressing/cast
Assess for the 6 P's:
• Pain
• Pallor – paleness
• Paresthesia – loss of sensation
, • Pulselessness – lack of pulse via palpation/auscultation
o Check distal pulses where the cast is located
• Paralysis – temporary/permanent loss of motor control
• Poikilothermia – affected limb cooler than unaffected limb
Nursing Interventions for Compartment Syndrome:
• Cast or restricted bandages must be removed immediately
• Perform neurovascular checks (6 P’s)
• Keep extremity AT HEART LEVEL (not below)
Fasciotomy
• A surgical incision through the fascia to relieve tension/pressure
Why is urine input important to monitor with compartment syndrome?
• Damaged muscle cells will be excreted in the urine (protein in the urine)
Rhabdomyolysis
• Breakdown of skeletal muscle due to injury
• Can lead to kidney damage if not treated
Crutches
• Assist weak/injured patients with walking
• Top of crutches: 2 inches below armpits
• Handgrips: even with the hips
Gaits (walking styles with crutches):
