b. A patient in a large cast will not be able to bathe without assistance.
However, the patient must be encouraged to do as much for himself as is possible.
Nursing personnel assist with those hygiene needs that the patient cannot manage
alone. Each time the patient is turned to the prone position, wash the exposed back
and buttocks and dry thoroughly. Apply lotion or powder and gently massage the skin
to stimulate circulation.
c. When assisting with a urinal or bedpan, elevate the back and shoulders
slightly higher than the buttocks to prevent dampening or soiling of the cast. Pillows
may be used for support or, if the physician permits, the bed may be gatched up.
Assist male patients with placement and removal of the urinal, if
(2) An emesis basin, slipped in place lengthwise, may be used by female
patient for voiding. The basin is easier to place and remove than a bed pan.
(3) When assisting a patient with a bedpan, be certain that the buttocks are
resting on the rim of the bedpan. The patient's head, shoulders, and back should be
higher than the buttocks if at all possible.
(4) When a trapeze can be used, instruct the patient to lift straight up in
order to avoid friction on the skin when placing and removing the bedpan.
(5) After using the urinal or bedpan, assist the patient to clean himself
thoroughly. Check cast edges for soiling or dampness.
1-23. TURNING A PATIENT IN A SPICA CAST
Patients in body or spice casts must be turned from supine to prone to permit the
cast to dry, to prevent pressure areas by redistribution of body weight, and to prevent
respiratory and urinary complications. The patient is turned initially as ordered by the
physician and must usually be turned a minimum of every two hours (unless otherwise
indicated by the physician) for as long as he remains in the cast. Until the cast is
thoroughly dry, at least three people should turn the patient so that there is no strain on
the patient or on the damp cast. As the patient becomes accustomed to the cast and
learns to help himself, less assistance may be required in turning the patient.
a. In any turning procedure, the patient must be turned "as a unit" with the
affected side ("bad side") uppermost. The patient should be turned, or log-rolled,
toward the unaffected side of his body ("good side").
b. Utilizing the pillows on which the patient is resting, and/or a draw sheet, move
the patient to the side of the bed with a steady, even, pulling motion. Remember that
the patient must be moved as a unit. When the patient is in the proper position, his "bad
side" will be at the edge of the bed and his "good side" will be near the center of the