depend upon the type of cast applied. A standard short arm cast or long arm cast can
normally be adequately supported with the triangular bandage sling. See figure 1-13.
[Note: Cast is not shown.] A sling does not support the arm above heart level so, in
order to promote drainage and reduce swelling, the patient should be encouraged to
remove the sling and raise the arm above his head periodically.
Figure 1-13. Triangular bandage sling.
c. If permitted by the physician, the patient should be encouraged to exercise
his muscles. Isometric muscle contractions (contracting the muscle without moving the
part) may be done to prevent atrophy and maintain muscle strength.
(1) If the patient is in a leg cast, have him lie down, place your hand under
his knee and instruct him to "push down" toward your hand.
(2)
If the patient has an arm cast, instruct him to make and release a tight
fist.
(3)
Encourage the patient to wiggle his fingers and toes frequently.
1-22. NURSING MANAGEMENT OF PATIENTS WITH BODY OR SPICA CASTS
a. When a large cast, such as a body cast or spice cast, is applied, the curves of
the cast must be supported in order to prevent sagging and pressure. Support should
be given to the entire cast, especially at weak areas such as the shoulder, hip, and
knee. Small plastic-covered pillows should be placed under the cast in such a manner
that there are no gaps between pillows.
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