A nurse cares for a client placed in skeletal traction. The client asks, “What is the primary purpose of this type of traction?” How would the nurse respond?

Choice A reason: Placing the client in a high-Fowler position may improve breathing but does not assess the cause of shortness of breath. Post-femur repair, pulmonary embolism (PE) is a risk due to fat emboli or thromboembolism, requiring objective data like oxygen saturation first.
Choice B reason: New-onset shortness of breath and tachypnea post-femur repair suggest possible pulmonary embolism or fat embolism syndrome. Documenting oxygen saturation provides objective data to assess hypoxia severity, guiding urgent interventions and communication with the healthcare provider for suspected life-threatening conditions.
Choice C reason: Starting oxygen therapy assumes hypoxia without confirmation. While it may be needed, assessing oxygen saturation first ensures the intervention is appropriate. Unwarranted oxygen administration could delay critical diagnostic steps for conditions like pulmonary embolism, which require anticoagulation or other therapies.
Choice D reason: Contacting the provider is important but secondary to assessing oxygen saturation, which provides critical data to report. Without objective findings, the nurse cannot convey the urgency or specifics of the client’s condition, potentially delaying life-saving interventions for suspected embolism.

Choice A reason: Anorexia is not a hallmark late sign of RA. It may occur early due to systemic inflammation but is less specific in late stages, where joint damage and systemic complications like Felty syndrome dominate.
Choice B reason: Felty syndrome, a late RA complication, involves neutropenia, splenomegaly, and recurrent infections due to chronic immune activation. It occurs in long-standing RA, reflecting severe disease progression, making it a key late finding.
Choice C reason: Joint deformity (e.g., swan-neck, boutonniere) is a classic late RA sign due to chronic synovial inflammation eroding cartilage and bone, causing joint instability and deformation, significantly impacting function in advanced disease.
Choice D reason: Low-grade fever is an early RA symptom due to systemic inflammation but typically diminishes in late stages. Chronic joint damage and systemic complications are more prominent, making fever less characteristic of late RA.
Choice E reason: Weight loss is a late RA sign due to chronic inflammation, increased metabolic demand, and cytokine activity (e.g., TNF-alpha). It reflects disease severity and systemic impact, common in advanced RA with joint destruction.