Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What is an essential aspect of immediate postoperative cast care?

1. Monitor for signs of infection only

2. Assess for cast dryness, fit, perfusion, and NV checks

3. Keep the cast dry and apply ice

4. Elevate the cast above heart level at all times

The correct answer is: Assess for cast dryness, fit, perfusion, and NV checks

The correct choice involves several crucial components necessary for effective immediate postoperative cast care. Assessing for cast dryness, proper fit, and perfusion, along with neurovascular checks, is vital to ensuring that the cast is functioning as intended and that the underlying limb remains healthy. The cast must be dry to maintain its structural integrity and to avoid skin irritation or infection. Evaluating the fit ensures that the cast is not too tight or too loose, both of which can cause complications like pressure sores or inadequate immobilization. Checking perfusion is important for assessing blood flow to the limb, and this is often indicated by monitoring capillary refill, warmth, and color of the toes or fingers beyond the cast. Neurovascular checks are critical for identifying any early signs of complications, such as compartment syndrome or nerve damage. While keeping the cast dry and applying ice, as well as elevating the cast, are important practices in postoperative care, they are not as comprehensive in addressing potential issues that might arise without proper assessments. Monitoring for infection is also crucial, but it's a narrower focus compared to the broader scope of cast care, which includes fit and circulation assessments. Thus, option B encapsulates the multifaceted approach required for effective cast management after a surgical procedure.