A child with a hip spica cast is being prepared for discharge. ...

[Jramos095]

A child with a hip spica cast is being prepared for discharge. Recognizing that caring for a child at home is complex, the nurse should include what instructions for the parents' discharge teaching?
 
  a. Turn every 8 hours.
  b. Specially designed car restraints are necessary.
  c. Diapers should be avoided to reduce soiling of the cast.
  d. Use an abduction bar between the legs to aid in turning.

Question 2

A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What technique should the nurse suggest to remove this material?
 
  a. Soak in a bathtub.
  b. Vigorously scrub the leg.
  c. Carefully pick material off the leg.
  d. Apply powder to absorb the material.

[dpost18]

Answer to Question 1

ANS: B
Standard seat belts and car seats may not be readily adapted for use by children in some casts. Specially designed car seats and restraints meet safety requirements. The child must have position changes much more frequently than every 8 hours. During feeding and play activities, the child should be moved for both physiologic and psychosocial benefit. Diapers and other strategies are necessary to maintain cleanliness. The abduction bar is never used as an aid for turning. Putting pressure on the bar may damage the integrity of the cast.

Answer to Question 2

ANS: A
Simply soaking in the bathtub is usually sufficient for removal of the desquamated skin and sebaceous secretions. Several days may be required to eliminate the accumulation completely. The parents and child should be advised not to scrub the leg vigorously or forcibly remove this material because it may cause excoriation and bleeding. Oil or lotion, but not powder, may provide comfort for the child.

[Jramos095]

TYSM

[diana chang]

Excellent