For a patient with a newly applied cast, which action is not recommended?

• A. Elevate the limb to reduce swelling
• B. Avoid getting the cast wet
• C. Check color and sensation regularly
• D. Use a heating pad on the cast

Answer: (D)

When a cast is newly applied, the focus is on protecting the skin, keeping the limb comfortable, and watching for signs of compromised blood flow or nerve function. Elevating the limb helps reduce swelling and pain by lowering hydrostatic pressure. Keeping the cast dry is essential because moisture can weaken the material and irritate the skin beneath, leading to maceration or infection. Regular neurovascular checks—observing color, temperature, sensation, and movement—allow early detection of problems like compromised circulation or nerve compression.

Applying a heating pad to the cast is not advisable. Heat can burn the skin under the cast, especially if sensation is diminished, and it can also soften or damage the cast material, increasing the risk of skin injury and cast deformation. If any new or worsening symptoms arise—such as increased pain, numbness or tingling, color changes, or swelling—seek medical attention promptly.