A nurse is caring for a client who is in Buck's traction. Which of the following actions should the nurse take? (Select all that apply.)
Position weights against the foot of the bed,
Examine the skin under the traction splint.
Monitor peripheral pulses in the affected extremity.
Assess the temperature of the affected extremity.
just the prescribed weights every shift.
Correct Answer : B,C,D
A. Position weights against the foot of the bed: Incorrect. Weights in Buck's traction are typically hung freely over the end of the bed to provide the necessary countertraction. Placing them against the foot of the bed would not serve this purpose.
B. Examine the skin under the traction splint: Correct. It's important to regularly assess the skin underneath the traction splint to ensure there are no signs of pressure ulcers or skin breakdown.
C. Monitor peripheral pulses in the affected extremity: Correct. This is essential to ensure that blood flow to the extremity is not compromised by the traction.
D. Assess the temperature of the affected extremity: Correct. Monitoring the temperature helps in identifying any signs of impaired circulation.
E. Adjust the prescribed weights every shift: This is not something that should be done without specific orders from the healthcare provider. Adjusting the weights should be done based on the specific plan of care and provider's instructions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. An IV infusion pump may be needed for intravenous therapy but is not specific to postoperative care following intermaxillary fixation.
B. This option is correct. Wire cutters are essential equipment in case of an emergency that requires the removal of the fixation wires.
C. An NG tube may be necessary for nutritional support, but it is not directly related to postoperative care following intermaxillary fixation.
D. A urinary catheter tray is not specific to postoperative care following intermaxillary fixation and may not be a priority in this situation.
Correct Answer is D
Explanation
A. Instructing the client on the use of crutches is important but not the most crucial immediately postoperatively. Ensuring the client's neurovascular status is stable takes priority.
B. Directing the client to perform ankle and toe exercises is important for preventing complications like deep vein thrombosis (DVT) and maintaining joint mobility. However, it is not the most critical action in the immediate postoperative period.
C. Medicating the client for pain is essential for comfort and recovery, but it should be based on a pain assessment and should not take precedence over assessing neurovascular status.
D. Performing neurovascular checks of the extremities is the most crucial action in the postoperative period after orthopedic surgery. It helps to ensure there is adequate blood flow and nerve function to the affected limb, which is essential for preventing complications such as compartment syndrome or vascular compromise.
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