A nurse is reinforcing teaching about home management with the partner of a client who has dementia. Which of the following instructions should the nurse include in the teaching?

Rationale:

A. The weights apply a pulling force continuously: Buck’s traction is a form of skin traction used to immobilize fractures and reduce muscle spasms. The weights must hang freely and provide a constant pulling force to maintain alignment and promote healing.

B. The boot allows active leg movement: In Buck’s traction, the affected leg should be immobilized. Active movement would interfere with the consistent traction force and compromise the effectiveness of the treatment.

C. The footplate rests against the foot of the bed: The client’s foot should not press against the bedframe or footplate, as this can counteract the traction force and cause improper alignment. There should be adequate space for traction to be effective.

D. The weights are just touching the floor: Weights should hang freely and never touch the floor. If they rest on the floor, the traction force is lost, defeating the purpose of the setup and potentially leading to complications.

Rationale:

A. "Discontinue the medication. I will ask your provider for another antibiotic.": Calf pain in a client taking ciprofloxacin may indicate tendinitis or even tendon rupture, a serious adverse effect associated with fluoroquinolones. The nurse should advise discontinuation of the drug and alert the provider immediately to prevent permanent damage.

B. "That reaction means your dose is too high. Cut the pill in half.": Reducing the dose without provider approval is unsafe and does not address the underlying risk of tendon injury. Ciprofloxacin-related tendinopathy is not dose-dependent and requires immediate discontinuation.

C. "Continue to take the medication. Calf pain is a minor reaction that will resolve itself.": Calf pain during ciprofloxacin therapy should never be dismissed as minor, since it may signal tendon inflammation or rupture.

D. “This is an allergic reaction. Take the medication with an antihistamine.": Tendon-related adverse effects are not allergic reactions and will not respond to antihistamines. Misclassifying the symptom as an allergy delays the proper intervention and increases the risk of irreversible tendon damage.