Orthopedic Nursing Care

Traction and Immobilization

• Provides comfort by reducing muscle spasm and provides fracture immobilization
• Lengthens the fractured leg to prevent severing of blood vessels

Skeletal Traction

• Prevents complications by inspecting the skin on the right leg at range of motion exercises daily
• Prevents complications by giving pin care once a shift
• Release of weights every shift to relax the limb is not recommended

Buck's Extension Traction

• Provides counteraction to reduce shear and friction by slightly elevating the foot of the bed
• Not used to provide rigid immobilization of the fracture site

Ambulation with Crutches

• Incorrect to use the axillae to help carry the weight
• Incorrect to take long strides to maintain maximum mobility
• Keep feet 12" (30 cm) apart to provide stability and a wide base of support
• All weight should be on the hands

Crutch Measurement

• Crutches cannot rest up underneath the arm for extra support to prevent skin breakdown in the area of the axilla
• Crutches cannot rest up underneath the arm for extra support to prevent injury to the brachial plexus nerves
• Crutches cannot rest up underneath the arm for extra support to prevent a fall and further injury

Compartment Syndrome

• Early symptom of compartment syndrome is pain that increases when the arm is independent
• Not relieved by oxycodone and aspirin (Percodan)
• Not characterized by cold, bluish-colored fingers
• Not characterized by numbness and tingling in the fingers

Nursing Interventions

• Priority intervention for a client with a fractured femur and skeletal traction is frequent neurovascular assessments of the affected leg
• Not maintaining proper body alignment
• Not inspection of pin sites for evidence of drainage or inflammation
• Not applying an over-bed trapeze to assist the client with movement in bed

Neurovascular Assessment

• Priority intervention for a 4-year-old with skeletal traction for treatment of a fracture of the right femur is notification of the healthcare provider
• Not readjusting the traction
• Not administering the ordered prn medication
• Not reassessing the foot in fifteen minutes

Russell's Traction

• Associated with auscultating the lungs for atelectasis
• Not checking the skin on the sacrum for breakdown
• Not inspecting the pin site for signs of infection
• Not performing a neurovascular check for circulation

Diversional Activity

• Appropriate diversional activity for a 5-year-old child with skeletal traction is playing hand-held games
• Not kicking balloons with the right leg
• Not playing "Simon Says"
• Not throwing bean bags

Skin Care

• Useful action to provide good skin care to a client in skeletal leg traction is asking the client to pull up on a trapeze to lift the hips off the bed
• Not asking the client to lift up by digging into the administering care
• Not pushing down on the mattress of the bed while administering care
• Not having another nurse turn the client anyway

Pin Site Evaluation

• Least concerned with serous drainage as a finding
• Concerned with purulent drainage as a finding
• Concerned with pain at a pin site as a finding
• Concerned with inflammation as a finding

Nursing Diagnosis

• Appropriate nursing diagnosis for a client immobilized in skeletal leg traction is deficient diversional activity
• Not powerlessness
• Not self-care deficit
• Not impaired physical mobility

Pain Management

• First action to take for a client with severe left leg pain in skeletal traction is to check the client's alignment in bed
• Not medicating the client with an analgesic
• Not providing pin care
• Not calling the physician