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167 Cards in this Set

  • Front
  • Back
What does venous thromboembolism (VTE) include?
deep vein thrombosis (DVT)
pulmonary embolism (PE)
DVTs often develop in people who are immobile because of?
DVTs are the most common complication of?
lower extremity surgery or trauma
DVTs are the most fatal complication of?
musculoskeletal surgery
Who may be at risk for DVTs?
heart disease
taking oral contraceptives or
history of thromboembolitic
The incidence of life-threatening embolic conditions is highest in older adults, particularly during the first ___ to ___ days after musculoskeletal surgery, usually hip repair
two to three days
DVT that leads to PE is more likely to develop in clients with fractures of the _____ _____ and _____.
lower extremities
Local venous stasis secondary to trauma or surgical procedures (? give an example ?) increases the chance of VTE in clients with musculoskeletal trauma.
use of tourniquets in lower extremity injuries
Define blood clot embolism?
obstruction of pulmonary artery by a blood clot or clots
What is the origin of blood clot embolism?
85% from deep vein thrombosis in the legs or pelvis; can occur anytime
What is the assessment finding for blood clot embolism?
altered mental status
(earliest sign)
increased respirations,
pulse, temperature
chest pain
decreased Sao2
retinal hemorrhage (not
mild thrombocytopenia

(these are the same as for fat embolism, except no petechiae)
Treatment for blood clot embolism?
preventive measures (e.g., leg exercises, antiembolism stockings, SCDs)
possibly mechanical
possible surgery; pulmonary
embolectomy; vena cava
___ ____ are the most common type of infection resulting from orthopedic trauma
wound infection
Wound infections range from _____ skin infections to ____ wound abscesses.
Infection can also be caused by _____ _______ used to repair a fracture surgically, such as pins, plates, or rods.
implanted hardware
_____ infections can result in gas gangrene or tetanus and can prevent the bone from healing properly.
What is osteomyelitis?
bone infection
Osteomyelitis is most common with ____ ____ in which skin integrity is lost and after surgical repair of a fracture.
For clients experiencing this type of trauma, the risk of _____-_____ _____ is increased.
open fractures

hospital-acquired (nosocomial) infections
Define osteonecrosis, ischemic necrosis, aseptic necrosis, avascular necrosis?

(all are the same condition)
blood supply to bone is disrupted, which results in death of bone tissue...often a complication of hip fractures or any fracture in which there is displacement of bone...surgical repair of fractures also can lead to necrosis because the hardware can interfere with circulation
____ ______ are associated most commonly with high-energy fractures and twisting injuries in the lower extremities.
Fracture blisters
With fracture blisters, extensive tissue edema allows fluid to move into the weakened space between _______ and ______. The increased 2______ _____pressure then pulls more fluid into the space. Fracture blisters can lead to 3_____ infection and delayed fracture treatment, which may then contribute to potential nonunion. Nursing measures that can assist in preventing or minimizing fracture blisters include maintaining proper ______ before definitive treatment and elevation to limit edema.
1 epidermis and dermis
2 colloidal osmotic
3 wound
4 immobilization
_____ union describes a fracture that has not healed within 6 months of injury.
Some fractures never achieve 1_____; that is, they never completely heal (2_____); others heal incorrectly (3_____). These problems are most common in clients with 4_____ fractures, fractures for which a number of different treatment techniques have been used (e.g., cast, traction), and pathologic fractures
1 union
2 nonunion
3 malunion
4 tibial
Union may also be _____ or not achieved in the older client.
If bone does not heal, the client typically experiences ___ and ____ from deformity.
Besides fractures, a cast may be applied for correction of _______, such as _____, or for prevention of deformities (rheumatoid arthrtitis-related).
A 1_______ is well-fitted and is placed under the cast. If it's too tight, it may impair 2______. If it's too loose, it may lead to development of 3___ ____ and skin breakdown.
1 stockinette
2 circulation
3 pressure ulcers
So the stockinette is next to the skin...1_____ is applied over the stockinette, followed by wet 2____ rolls wrapped around the extremity or other body part. The cast feels hot because an immediate 3_____ ____ occurs, but it soon becomes damp and cool. This type of cast takes 4____ to ___ hours to dry, depending on size and location of cast. A 5____ cast feels cold, smells musty, and is grayish. The cast is dry when it feels hard and firm, is odorless, and has a shiny white appearance. The outside material is plaster-of-Paris (anhydrous calcium sulfate)
1 padding
2 plaster
3 chemical reaction
4 24 to 72 hours
5 wet
The rough edges of a cast can cause _____ because of crumbling. ______ the cast will resolve this problem, if the underlying stockinette does not cover the edges of the cast. Small strips of ____ are placed over the rough edges to protect the skin.
If skin under cast is disrupted, the hcp cuts a 1____ into the cast so that the wound can be observed and cared for. It is also used for taking 2____, removing wound 3____, or relieving abdominal distention when the client is in a body or 4____ cast.
1 window
2 pulses
3 drains
4 spica
What is bivalving a cast?
cutting it lengthwise into two equal pieces...either half can be removed for inspection or care...the two halves are then reunited by an elastic bandage wrap
If a cast is too tight, it can be cut or _____ if bone healing is almost complete.
What are some synthetic materials for casts (2)?
polyester-cotton knit

(lightweight and minimal drying time; synthetic is used more often than plaster-of-Paris)
Fiberglass casts dry in ___ to ____ minutes and can bear weight ____ minutes after application.
10 to 15
Polyester-cotton knit casts take ___ minutes to dry and can withstand weight bearing in about ____ minutes.
Some health care providers use 1 ____ casts for upper extremities and 2____-___-___ casts for lower extremities because it can bear more weight for a longer time.
1 synthetic
2 plaster-of-Paris
Casts can be generally divided into four main groups?
arm casts
leg casts
cast braces
body casts
spica casts
When a client is in bed with ARM CAST, the arm is 1____ ___ the heart to reduce swelling. The hand should be 2____ than the elbow.
Ice may be prescribed for the first 3____ to ____ hours.
Use a sling for comfort. The sling should distribute the weight over a large area of the 4_____ and 5_____, not just the neck.
1 elevated above
2 higher
3 24 to 48
4 shoulders
5 trunk
Some hcps advise against the use of a sling after a few days because?
not using a sling after a few days encourages normal movement of the mobile joints and enhances bone healing
(this is especially true of short-arm cast)
A LEG CAST permits mobility and requires the client to use ____ _____, such as ____.
ambulatory aids
A cast shoe, sandal, or boot that attaches to the foot or a rubber walking pad attached to the sole of the cast assists in ambulation (if weight bearing is allowed) and helps prevent?
damage to the cast
With a leg cast, the affected leg is elevated on several pillows to reduce swelling, and ice is applied for the first ___ hours or as prescribed.
24 hours
A 1___ ____ enables the client to bend unaffected joints while the fracture is healing. The fracture 2___ show signs of healing and minimal tissue edema before application of this cast. Two 3_____ casts are made and connected by a hinge to allow joint movement. As healing occurs, the casts may be removed and replaced with a 4____ ____. Commercial immobilizers, which serve the same function as a cast brace, are available and may be used in some cases.
1 cast brace
3 cylindrical
4 soft brace
A 1____ ____ encircles the trunk of the body; a 2____ cast encases a portion of the trunk and one or two extremities...special challenges for nursing care.
1 body cast
2 spica
Potential complications related to severe impairment in mobility exist for use of a spica cast (body cast). These include (4)?
skin breakdown
respiratory dysfunction,
such as pneumonia and
joint contractures
What is an uncommon, but serious complication seen in orthopedic clients who have been placed in a hip spica or body cast?
cast syndrome (superior mesenteric artery syndrome)
In cast syndrome (superior mesenteric artery syndrome), there is partial or complete upper intestinal obstruction resulting in what classic symptoms (4)?
abdominal distention
epigastric pain

(the vomiting often occurs after meals, and clients may have normal bowel sounds)
In cast syndrome (sup. mes. art. syn), partial obstruction occurs initially from compression of the third portion of the 1____ between the superior mesenteric artery and the 2____. This progresses to complete obstruction from duodenal edema caused by continued vomiting and distention. Placing a 3____ in the abdominal portion of the cast or 4____ the cast may be sufficient to relieve pressure on the duodenum. Management of intestinal obstruction is the same as for any client with this complication.
1 duodenum
2 aorta
3 window
4 bivalving
With plaster casts, be sure to warn the patient that ___ will be felt after the wet cast is applied and that the new cast is not covered to facilitate ___-___
When a client with a wet plaster cast is moved and turned, the cast is handled with the ____ of the hands to prevent indentations and resultant areas of pressure on the skin.
The client is turned every ___ to ___ hours to allow air to circulate and dry all parts of the cast.
1 to 2
If the client is hospitalized, a sign is placed at the head of the bed as a reminder that?
the cast is wet and requires special handling.
If the hcp requests that the cast be elevated to reduce swelling, a 1___-___ pillow is used instead of one encased in plastic, which could cause the cast to retain heat and prevent drying.
1 cloth-covered
Elevation of the casted extremity reduces 1___ but may impair arterial circulation to the affected limb.
1 edema
Types of cast braces (or brace casts) (2)?
patellar weight-bearing cast
extremity polycentric knee
hinge cast
Type of body casts? (3)
hip spica
Risser's cast
halo cast
Use and description of a short arm cast (SAC)?
upper extremity...
extends from below elbow to and including part of the hand...
used for stable fractures of the wrist (metacarpals, carpals, or distal radius
Use and description of a long-arm cast (LAC)?
upper extremity cast...
includes the upper arm to and including part of the hand...
includes the upper arm to and including part of the hand
Use and description of a hanging-arm?
upper extremity cast...
same as LAC but heavier, with added loop at the mid-forearm...
fractures of the humerus that cannot be aligned by LAC (light traction is possible while the client is in bed or by an attached strap that extends around the neck
Use and description of a thumb spica cast?
upper extremity cast...
similar to SAC with the thumb casted in abduction...
fractures of the thumb
Use and description of a shoulder spica cast?
upper extremity casts...
the shoulder is casted in abduction with the elbow flexed...
unstable fractures of theh shoulder girdle or humerus; dislocations of the shoulder
Use and description of a short-leg cast (SLC)?
lower extremity cast...
from below the knee to the base of the toes...
fractures of the ankle, metatarsals, or foot
Use and description of a long-leg cast (LLC)?
lower extremity casts... from the mid-upper thigh to the base of the toes...
unstable fractures of the tibia, fibula, ankle
Use and description of a walking cast?
lower extremity cast...
a walking device on the bottom of SLC or LLC...
same as for SLC or LLC
Use and description of a leg cylinder?
lower extremity cast...
similar to SLC, but the ankle and foot ar not casted...
stable fractures of the tibia, fibula, or knee
Use and description of a long-leg cylinder?
lower extremity casts...
ankle andn foot are not casted...
stable fractures of the distal femur, proximal tibia, or knee
Use and description of a patellar weight-bearing cast?
cast brace (brace cast)...
similar to SLC or leg cylinder...
midshaft or distal shaft fractures of the femur
Use and description of an external polycentric knee hinge cast?
cast brace (brace cast)...
a hinge connects the lower and upper leg and allows 90 degrees of knee flexion...
same as for patellar weight-bearing cast
Use and description of a hip spica?
body cast...
extends from below the nipple line down the affected leg {single}, down the leg and half of the unaffected leg {1.5), or down both legs {double}...
dislocation of the hip; pelvic or hip injuries
Use and description of a Risser's cast?
body casts...
the body jacket extends from the shoulders to beyond theh iliac crests and hips, with a large opening over the anterior chest)...
scoliosis; thoracic spinal fractures
Use and description of a halo cast?
body casts...
the body jacket contains a halo brace...
fractures of the cervical spine
For preventing contamination by ___ or ____, the perineal area of a dry long leg or body cast is encased in a plastic protective covering.
urine or feces
_____ pans are preferred over traditional bedpans because they are smaller and more comfortable for the client. Care is taken to prevent spillage on client.
Check to ensure the cast is not too tight and fequently monitor the client's neurovascular status, usually every hour for the first ____ hours after able to insert a finger between the cast and the skin. ____ may be applied for the first ___ hours to reduce swelling and inflammation.
Once the plaster cast is dry, it is inspected at least once every ___ hours for drainage, cracking, crumbling, alignment, and fit.
Plaster casts act like ____ and absorb drainage, whereas synthetic casts act like a ____, pulling drainage away from the drainage site.
1____ can also absorb wound drainage...drainage on any cast should always be measured and documented in the client record; circling drainage on cast may cause 2____ and is controversial.
1 Padding
2 anxiety
_____ report to the hcp any sudden increases in the amount of drainage or change in the integrity of the cast.
After ____ decreases, it is not uncommon for the cast to become too loose and need replacement.
What are some casting complications that should be monitored during hospitalization and then patient teaching on discharge?
circulation impairment
peripheral nerve damage
_____ most often results from the breakdown of skin under the cast (pressure necrosis)
If pressure necrosis occurs, the client typically complains of a very painful "____ ___" under the cast, and the cast may feel warmer in the affected area.
"hot spot"
Smell the area for _____ or an unpleasant odor that would indicate infected material. If the infection progresses, a ____ may develop.
1_____ impairment and peripheral nerve damage can result from constriction of the cast.
1 Circulation
A client with a new cast may require _____ neurovascular assessments.
A client with a cast that is ___ or ___ days old usually requires assessments every ___ to ____ hours.
3 or 4 days
4 to 8 hours
The client with a cast may be _____ for a prolonged period, depending on the extent of the fracture and type of cast.
What are signs of immobility to assess for?
skin breakdown
What may the client feel while the cast is being removed?
Because of prolonged immobilization, a joint may become ______, usually in a fixed state of flexion, or degenerative arthritis may develop from lack of weight bearing, which is necessary for _____ viability.
Besides degenerated cartilage, _____ atrophy can occur from lack of exercise during prolonged immobilization of the affected body part, usually an extremity
Define traction?
application of a pulling force to a part of the body to provide reduction, alignment, and rest.
What can traction decrease?
muscle spasm...this relieves pain, as well as corrects deformity and tissue damage...requires longer hospitalization
What are two types of mechanical traction?
continuous, as in fracture
intermittent, for relief of
muscle spasm in other types
of musculoskeletal/
neurologic trauma, such as
cervical nerve root
Traction may also be classified as? (2)
running traction
balanced suspension
What is running traction?
the pulling force is in one direction and the client's body acts as countertraction
What can alter running traction force?
moving the body or bed position
Why is balanced suspension important in countertraction?
so that the pulling force of the traction is not altered when the bed or client is moved....allows for increased client movement and facilitates care
Traction is typically one of five types?
skin traction
skeletal traction
plaster traction
brace traction
circumferential traction
Skin traction involves the use of a _____ boot (Buck's traction), belt, or halter, which is secured around a body part.
What is the primary purpose of skin traction?
to decrease painful muscle spasms that accompany fractures
About how many pounds are used as a pulling force so as not to prevent injury to the skin?
5 to 10 pounds
In skeletal traction, pins, wires, tongs, or screws are surgically inserted directly into ____?
Skeletal traction uses 1____ traction time and 2____ weights, usually 15 to 30 pounds...aids in bone 3______
1 longer
2 heavier
3 realignment
_____ traction combines skeletal traction and a plaster cast.
A brace traction device exerts a ____ for correction of alignment deformities.
_______traction uses a belt around the body, such as pelvic traction for low back problems.
Once traction is applied, maintain the correct balance between traction _____ and countertraction _____.
Weights are NOT USUALLY removed without an _____ and are not usually lifted _____ or allowed to set on the floor. Weights should be freely ______ at all times.
When in traction, inspect the skin at least every ___ hours for signs of ____ or inflammation.
8 hours
When possible, remove the belt or boot that is used for skin traction every ___ ___ to inspect under the device.
8 hours
When skeletal traction is used, pay particular attention to the points of entry of ____, ____, and ____ for signs of inflammation or infection. A small amount of clear fluid drainage ("weeping") is _____. Most hcps prefer that pin care is performed every day.

When in traction, observe pin sites at least every ____ hours for drainage, color, odor, and severe redness, which indicate inflammation and possible infection
8 hours
Cleaning the pins may disrupt skin's natural barrier to _____...may be advised against it.
Infection of the pin _____ MAY result in osteomyelitis.
The nurse is responsible for checking _____equipment to ensure its proper functioning.
The nurse should check all ropes, knots, andn pulleys at least every ___ ___ for loosening, fraying, and positioning.
8 hours
Check the traction weight for consistency with ___ order...order can be changed without person responsible to confirm change
Sometimes one of the weights is accidentally _____ by a staff member or visitor who bumps into it. Replace the weights if they are not correct, and notify the hcp or orthopedic technician.
If the client complains of severe ____ from muscle spasm, the weights may be too heavy or the client may need realignment. ____ pain to hcp if body realignment fails to reduce the discomfort.
Assess ______ status of the affected body part to detect circulatory compromise and subsequent tissue damage.
The circulation is usually monitored every ____ for the first ___ ___ after traction is applied and every __ ___ thereafter.
24 hours
4 hours
For some types of fractures, surgical intervention is necessary.
What is the PREOP care for fractures if surgery is indicated?
possible traction
(ex: fractured hip using
Buck's traction)
general or epidural
What is open reduction with internal fixation (ORIF)?
a common method of reducing and immobilizing a fracture...used with elders as it permits early mobilization

(if this isn't feasible, then, external fixation with closed reduction is used)
What is open reduction?
allows the surgeon direct visualization of the fracture site
What is internal fixation?
uses metal pins, screws, rods, plates, or prostheses to immobilize the fracture during healing
With INTERNAL fixation, why does the surgeon make an incision?
to gain access to the broken bone and then implants one or more devices
With internal fixation, there is a new bioabsorbable plate, a device which is strong enough to fix the fracture but is resorbed by the body in about ___ ___.
3 months
What is EXTERNAL fixation?
fracture is reduced ...
physician makes small percutaneous incisions so that pins may be implanted into the bone..all pins are self-drilling...the pins are held in place by an external metal frame to prevent bone movement
What are the advantages of EXTERNAL fixation over other immobilization techniques?
blood loss minimal in comparison with internal
ambulation earlier..
exercise earlier..
alignment maintained in
closed fractures which
may not be achieved with a
comminuted fractures that
require bone grafting are
access easier to wound with
open fractures
What are the disadvantages of EXTERNAL fixation?
pin-tract infection which may lead to may have to be performed several times a day using skeletal traction pin care the pins is controversial
With external pin care, inspect pin sites at least daily for severe?
redness, swelling, and purulent drainage
What are external fixators used for?
an extremity or for fractures of the pelvis...after a fixator is removed, the client may be placed in a cast until healing is complete...disturbed body image possible
Why might a client have a disturbed body image related to an external fixator?
because the frame may be large and bulky, and the affected area may have massive tissue damage with dressings
What are circular external fixators (Ilzarov) used for?
treats new fractures
open with bone loss
congenital bone deformities
A circular external fixation stimulates?
bone growth
Unlike the traditional fixator, the Ilizarov external fixator promotes (6)?
soft-tissue defect healing
widening of bone
With an Ilizarov external fixator, the nursing care is the same as with other external fixator systems...the major exception is?
if the device is being used for filling bone gaps, using bone transport or distraction, the client must be taught how to manually turn the four-sided nuts (clickers), usually 4 times per day, unless there is an automated device...1mm daily distraction rate is common...teach client carefully as he will have this apparatus for a prolonged time
Post-op care for ORIF (open reduction with internal fixation) is same as with other surgeries. As with other musculoskeletal surgeries, complications such as ___ ___ and ___ ____ are possible.

fat embolism
venous thromboembolism
If there is NONUION, other options are available which include (3)?
electrical bone stimulation
bone grafting (new)
ultrasound fracture treatment
What is electrical bone stimulation?
new technology
treats nonunion

1 system:
NON-INVASIVE...uses magnetic
coils applied on the skin
or over a cast to deliver
a pulsed magnetic field...
no known risks, just don't
use on upper extremity if
pacemaker present

2 system:
IMPLANTED direct-current stimulators are placed directly in the fracture site and have no external apparatus

both systems require about 6 months of treatment, and weight bearing is at the discretion of the hcp
What is bone grafting?
treats nonunion

may also replace diseased
bone or increase bone tissue for joint replacement.

in most cases, chips of bone are taken from the client's iliac crest or other site and are packed or wired between the bone ends to facilitate union

allografts from cadavers may also be used...these grafts are frozen or freeze-dried and stored under sterile conditions in a bone bank
What is bone banking?
living donors who undergo hip replacement can donate their femoral heads to a bank for later use as bone grafts for other clients...careful screening ensures that the bone is healthy and that the donor has no communicable disease...bone cannot be donated without client's written consent
What is low-intensity pulsed ultrasound (exogen therapy)?
treats nonunion...

used for slow-healing fractures or for new fractures as an alternative to surgery, ultrasound treatment has yielded excellent results...
the client applies the treatment for about 20 minutes each day
Expected outcomes for acute pain?
Client must take personal action against pain by?
preventive measure use
nonanalgesic relieve measure
analgesic relief measure use
report changes in pain
symptoms or sites to hcp
report uncontrollable pain
symptoms to hcp
report that pain is
Musculoskeletal pain is prolonged and severe, so hcp commonly prescribes what kind of drugs (3)?
opioid analgesics
muscle relaxants
The patient is suffering from severe, chronic central and peripheral pain. How does the hcp treat this?
gives opioid and nonopioid drugs alternately or given together
The nurse and client discuss when is the best time to give the strongest pain relievers...these times include?
before a complex dressingn change...
physical therapy...
While patient is on strong drugs for pain, the nurse needs to closely monitor (3)?
effectiveness of medication..
side effects
acute compartment syndrome
(ACS) which is often the
sudden inability of pain
medication to relieve
pain...patient might need
PCA or epidural anesthesia
The patient suffering from musculoskeletal pain cannot survive on pain medications alone...he must turn to?
ice or heat, depending on the
cause of pain
warm, soothing bath
back rub
use of therapeutic touch

if these don't work, turn to?
deep breathing
What is appropriate alternative therapy for a patient with swelling at the affected area?
ice and elevation of the affected body part
What is appropriate alternative therapy for muscle spasms?
heat and massage
1 Planning: Expected Outcomes for Risk of Infection is?

2 Client will have none of the following?
1 The client with a fracture is expected to be free of a wound or bone infection

2 foul-smelling discharge
purulent drainage
wound-site culture
colonization (if wound
white blood cell (WBC)
Strict aseptic technique is used for dressing changes and wound irrigations. If there are manifestations of 1 local inflammation and purulent drainage, what intervention should the nurse take?

2 other infections, such as ____ and ___ may occur days after the fracture

3 the client's vital signs are monitored every ___ to __ hours because increases in temperature and pulse often indicate systemic infection
1 call hcp immediately
2 pneumonia and UTIs
3 4 to 8 hours
What kind of drugs are prophylactically prescribed for patients with an open fracture, esp. those requiring surgical repair?
broad-spectrum antibiotics
1 The expected outcome for a client with a fracture is?

2 Indicators include that the client will have none of the following?
1 The client with a fracture is expected to be free of physiologic consequences of impaired mobility

2 pressure ulcers
urinary retention
contracted joints
venous thrombosis
While using prevent pressure on the axillary nerve, there should be 1__ to ___ finger breadths between the axilla and the tope of the crutch when the crutch tip is at least 2____ inches diagonally in front of the foot...the crutch is adjusted so that the elbow is flexed no more than 3___ degrees when the palm is on the handle
1 2 to 3
2 6 inches
3 30 degrees
The most common type of walking with crutches is the ___-___ ___, which allows minimal weight bearing on the affected leg.
three-point gait
When using a cane, use it on the ____ side and should create no more than ___ degrees of flexion of the elbow. The top of the cane should be parallel to the ____ _____ of the ____
greater trochanter of the
For promotion of bone and tissue healing, the client needs a 1____- ____, 2____-____ diet. Supplements of 3_____ _____ are required for tissue nutrition.
1 high-protein
2 high-calorie
3 vitamins B and C
Clients that are immobilized for extended periods are predisposed to?
hypocalcemia, which results in loss of calcium from bone and in subsequent bone fragility.
A negative nitrogen balance can develop ___ to ___ days after injury in an immobilized client because of an increase in catabolism without compensatory ____ intake.
7 to 10
What are some high-protein, high-calcium drinks for patients?
frequent small feedings and supplements of:
Carnation Instant Breakfast
milk shakes
Because of less weight bearing on long bones, the immobilized client with a fracture often becomes
1 ____. Blood loss from the injury or reparative surgery contributes to the 2____ state. Encourage intake of foods high in 3____ content. The hcp may prescribe a daily multivitamin with iron supplement.
1 anemic
2 anemic
3 iron
Nurse needs to assess barriers to mobility, such as ____, when patient is discharged from hospital.
Care of the extremity after cast is removed?

Remove scaly, dead skin carefully by 1_____, do not scrub.

Move the extremity carefully. Expect discomfort, weakness, and decreased 2____.

Support the extremity with pillows or your 3____ device until strength and movement return.

4_____ slowly as instructed by your physical therapist.

Wear support stockings or elastic bandages to prevent 5____ (for lower extremity)
1 soaking
3 orthotic
4 Exercise
5 swelling