- Determine amount and severity of pain if present.Ask client for descriptions;avoid coaching client with words to describe pain
- Ratioanale-manipulation and reduction may produce dull,aching pain as a result of pressure on nerve endings.Clients vary in perception and tolerence of pain.
Pallor
- Observe color of tissues distal of cast
- Rationale-pink indicates arterial pressure is normal,whitish color signifies decreased arterial supply, and bluish color signifies venous stasis.
Pulselessness
- When possible palpate distal pulse of casted extremity;note presence and strength of pulse.assess capillary refill by pressing on toenail or fingernail if cast is on extremity,releasing and noting pinking of nail;nail should pink up in 3 seconds or less.
- Rationale-weak and absent pulse may indicate decreased circulation.Blanching on pressure with subsequent capillary refill is indicative of arterial perfusion.Capillary refill is too sluggish if refill takes more than 3 seconds.It takes 2 seconds to say capillary refill is slowly and 4 seconds to repeat it once(Beare and Myers,1998).
Paresthesia
- Assess for numbness,tingling, or abnormal sensations.
- Rationale-may indicate nerve damage and/or development of compartment syndrome
Paraplegia
- Assess for motion
- Rationale-may indicate nerve damage and/or development of compartment syndrome
Resource from Clinical Nursing Skills and Techniques book, fifth edition (2002) by Mosby
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