A nurse is developing a plan of care for a child who is in skeletal traction following a femur fracture. Which of the following actions should the nurse include in the plan?

Lift the traction weights when repositioning the child in bed.

Have the child rate their level of pain ever-8 hr.

Monitor the neurovascular status of the child's lower extremities every 12 hr.

Educate the child's guardians about pin site care prior to discharge.

Answer and Explanation

The Correct Answer is D

A. Lift the traction weights when repositioning the child in bed.

This action should not be included in the plan of care because lifting the traction weights can interfere with the traction's effectiveness and potentially cause harm or injury to the child. The weights are specifically calibrated to provide the necessary tension for the traction to stabilize the fracture site.

B. Have the child rate their level of pain every 8 hours.

While pain assessment is an essential component of nursing care, the frequency of every 8 hours may not be sufficient, especially for a child in skeletal traction. Pain management should be more frequent and individualized based on the child's needs, which may vary throughout the day.

C. Monitor the neurovascular status of the child's lower extremities every 12 hours.

Neurovascular assessment is crucial for patients in traction to detect any signs of compromised circulation or nerve function. However, every 12 hours may not be frequent enough to promptly identify changes in neurovascular status. More frequent assessments, such as every 1-2 hours initially and then gradually decreasing based on stability, are typically recommended.

D. Educate the child's guardians about pin site care prior to discharge.

This is the correct answer. Educating the child's guardians about pin site care is essential to prevent infection and other complications associated with skeletal traction. Proper care of the pin sites reduces the risk of infection, which can lead to serious complications such as osteomyelitis. Providing education prior to discharge ensures that the guardians are equipped with the necessary knowledge and skills to care for the child at home effectively.

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Correct Answer is D, A, B, C.

Explanation

the correct sequence is D, A, B, C. Rationale: D (Mask self and the client): First, both the nurse and the client should wear masks to reduce the risk of infection during the procedure. A (Remove the old dressing): Next, the old dressing should be removed to expose the site. B (Create a sterile field): After removing the old dressing, a sterile field is created to maintain aseptic conditions. C (Apply precut gauze pads to the site): Finally, sterile precut gauze pads are applied to the site to protect the catheter.

A. Occupational therapist B. Chiropractor C. Acupuncturist D. Physical therapist

Correct Answer is D

Explanation

A. Occupational therapist: While occupational therapy may be beneficial for some aspects of managing sciatica, such as ergonomic assessments and activities of daily living modifications, a referral to an occupational therapist is not typically indicated specifically for the use of a TENS unit.
B. Chiropractor: Chiropractic care involves manual adjustments of the spine and other joints, which may provide relief for some individuals with sciatica. However, a referral to a chiropractor is not necessary solely for the use of a TENS unit.
C. Acupuncturist: Acupuncture is a complementary therapy that involves the insertion of thin needles into specific points on the body to relieve pain and promote healing. While acupuncture may be considered as part of a comprehensive treatment plan for sciatica, it is not typically associated with the use of a TENS unit.
D. Physical therapist: Physical therapy plays a crucial role in the management of sciatica. A physical therapist can provide tailored exercises, stretches, and modalities such as TENS therapy to alleviate pain, improve mobility, and strengthen muscles. Therefore, a referral to a physical therapist is appropriate for a client with sciatica who has a prescription for a TENS unit. The physical therapist can assess the client's condition, educate them on the proper use of the TENS unit, and integrate it into their overall treatment plan.

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A nurse is developing a plan of care for a child who is in skeletal traction following a femur fracture. Which of the following actions should the nurse include in the plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a peritoneal catheter that requires a dressing change. Identify the sequence of actions the nurse should take. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Correct Answer is D, A, B, C.

Explanation

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Correct Answer is D

Explanation

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