Which instructions does the nurse give to a patient with a long leg cast to prevent edema
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Usual recovery time The recovery time following a foot or ankle operation varies widely, depending on factors including how complex the surgery was, your age and general health, and your compliance with instructions (such as weight bearing status, rest, elevation). For most foot and ankle operations, tenderness and swelling can take 3-4 months to resolve, while for more complicated procedures, the recovery may take a full year (or more). Your first return visit On your first return visit, your cast or bandage will be removed for the first time. You should be aware that the foot and ankle will look nothing like it will when it is finally healed months down the line. In fact, for some patients, the sight can be somewhat alarming, given that the bandages may have dried blood on them, your foot and ankle may be somewhat swollen and bruised, and you may see stitches at the incision site(s) although often dissolving sutures are used which are invisible. If you have a cast on your leg, the cast will be removed by our orthopedic casting nurse on your first return visit. If you just have a bandage, but no cast, the bandage will be removed. I will see you once these tasks are completed. When I see you, I will assess your progress and review the recovery plan that I want you to follow until our next visit together. Resuming footwear The problems of bone healing and swelling prevent early return to normal footwear following most foot and ankle surgeries. There are a few operations where a patient can be expected to resume wearing standard footwear in as little as 2-3 weeks but the majority of foot and ankle operations take at least 8 weeks before standard footwear can be attempted. If the surgery requires a cast, then there is typically a 2-4 week period of weaning back to shoes after the cast is finally removed (a removable walking boot may be used during this weaning period). Therefore, if the surgery requires a cast or boot for 3 months, then you can expect to be in standard shoes no sooner than 14-16 weeks. I will discuss my expectations for your return to standard footwear with you both preoperatively and postoperatively. Return to work Since virtually all foot and ankle operations require rest and elevation of the operated foot for at least 2 weeks following surgery, it is rare that a patient will be allowed to return to work before 2 weeks following surgery. If you work in a sedentary occupation and can arrange your work environment so that you can continue to keep your foot elevated, it might be possible to return to work under these circumstances at approximately two weeks following some foot and ankle procedures. If you work at a job that requires you to be on your feet for a substantial portion of the workday, it is rare that you would be allowed to return to work in less than 8 weeks following your surgery. In more complex surgeries, patients may be required to remain off work for as much as 3-6 months. I will discuss my expectations for your return to work with you both preoperatively and postoperatively. Resuming activities Activities are usually progressed gradually in the following sequence: very restricted activities of daily living (ADL) with mandatory rest and elevation, restricted ADL with rest and elevation, full ADL with restricted footwear, ADL with standard footwear, non-impact exercise activities with standard footwear, and finally, full weight bearing exercise activities. The time it usually takes to progress through these levels is typically months, and is dependent upon how complex the surgery was, your age and general health, and your compliance with instructions (such as weight bearing status, rest, elevation). Therefore, it may take 2-6 months before full weight bearing exercise activities are started. Before full weight bearing activities are allowed, non-impact exercise activities may be allowed, including activities such as core strength work, upper body weight lifting, swimming, stationary cycling, and elliptical trainer. I will discuss my expectations for your return to activities with you both preoperatively and postoperatively. Rehabilitation Most foot and ankle operations require some form of rehabilitation. In most cases, I will give you instructions on the type, frequency, and duration of rehabilitation activities. These activities may include range of motion exercises and strength work that you perform on your own. In some cases, working formally with a physiotherapist may be required, for which I can make a referral. Rehabilitation activities may be started in some cases immediately after surgery, while in other cases, will be delayed until a cast or boot is removed. In most cases, rehabilitation activities may last for 2-12 months. Should you have any unanswered questions, please call us on 096300214 Which discharge instructions does the nurse give to a patient with a cast?Home care. Keep the cast dry. ... . Don't stick things in the cast, even to scratch the skin. ... . Don't cut or tear the cast.. Cover any rough edges of the cast with cloth tape or moleskin. ... . Never try to remove the cast yourself.. Don't pick at the padding of the cast. ... . Exercise all the nearby joints not immobilized by the cast.. Which action would a nurse perform on a clients cast to prevent skin irritation?Maintain skin integrity: petal the cast and use soft tape called moleskin around the edges to prevent skin breakdown.
Which intervention would the nurse expect to implement during the first 48 hours for a patient who has sustained a sprain?Try to ice the area as soon as possible after the injury and continue to ice it for 15 to 20 minutes, four to eight times a day, for the first 48 hours or until swelling improves.
Which nursing observation is the best indication that the client with a recent casted fracture may be developing compartment syndrome?Pain: The first and most reliable sign of compartment syndrome. Pain out of proportion to injury, extreme pain on passive movement and pain unrelieved with opioid analgesia. Paralysis: Is generally a late sign of compartment syndrome and results from prolonged nerve compression or muscle damage.
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