Good nursing care for a child in Buck's traction would include:
ensuring that the weights are hanging freely
providing meticulous pin care
positioning the child with hips flexed 90° at all times
releasing the weights on a schedule.
The Correct Answer is A
Buck’s traction is a form of skin traction used to immobilize lower extremity fractures by applying continuous longitudinal force to maintain alignment and reduce muscle spasm. Proper traction maintenance depends on uninterrupted, correctly aligned weight application to ensure therapeutic effectiveness and prevent complications such as pressure injury and neurovascular compromise.
Rationale:
A. Ensuring that the weights are hanging freely maintains continuous traction force, which is essential for proper alignment and fracture stabilization. Any obstruction or contact with the bed disrupts traction mechanics, leading to loss of alignment, increased muscle spasm, and potential neurovascular compromise.
B. Meticulous pin care is associated with skeletal traction, not Buck’s traction, which uses skin traction without pins. Therefore, pin site care is not indicated in this context and does not reflect appropriate management of Buck’s traction.
C. Positioning the child with hips flexed at 90° is incorrect because Buck’s traction requires neutral alignment of the limb. Excessive hip flexion alters traction pull, reduces effectiveness, and may worsen pain or deformity at the fracture site.
D. Releasing weights intermittently is contraindicated because traction must remain continuous to maintain fracture alignment. Removing weights disrupts the therapeutic pull, increases muscle spasm, and may cause displacement of the fracture fragments.
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Related Questions
Correct Answer is B
Explanation
Athetoid cerebral palsy is a non-progressive motor disorder caused by damage to the basal ganglia, particularly the extrapyramidal system, leading to impaired regulation of muscle tone and involuntary movement control. It results in fluctuating tone, poor postural control, and abnormal involuntary motor activity.
Rationale:
A. Headache, vomiting, and drowsiness are indicative of increased intracranial pressure rather than cerebral palsy. These symptoms suggest acute neurological deterioration such as hydrocephalus or intracranial hemorrhage. They are not characteristic of a chronic, non-progressive motor disorder like athetoid cerebral palsy.
B. Athetoid cerebral palsy is defined by involuntary movements due to basal ganglia dysfunction, resulting in slow, writhing, purposeless motions that worsen with voluntary activity. These movements interfere with coordinated motor function, speech, and feeding, and are hallmark features of extrapyramidal motor pathway injury.
C. Intellectual disability may coexist with cerebral palsy but is not defining for athetoid type. Cognitive impairment varies widely depending on extent of cortical involvement. Therefore, an IQ below 70 is not a specific or expected feature of athetoid cerebral palsy presentation.
D. Febrile seizures are common in early childhood due to immature thermoregulation of cortical neurons but are not directly associated with cerebral palsy. Cerebral palsy results from perinatal or early brain injury, not recurrent fever-induced seizure activity characteristic of febrile seizure disorders.
Correct Answer is D
Explanation
A Milwaukee brace is a cervicothoracolumbosacral orthosis used in the management of adolescent scoliosis to halt curve progression during skeletal growth. It applies corrective pressure to the trunk while allowing growth modulation, requiring prolonged daily wear with proper skin protection to prevent breakdown and ensure alignment correction.
Rationale:
A. Wearing the brace only during sleep is incorrect because therapeutic effectiveness depends on prolonged daily wear, typically 18–23 hours per day. Limiting use to sleep provides insufficient corrective pressure, allowing continued spinal curvature progression during active growth phases.
B. Using the brace only as needed for back pain is inappropriate because the Milwaukee brace is not an analgesic device but a structural correction orthosis. Intermittent use fails to maintain continuous spinal alignment forces required to prevent worsening of scoliosis.
C. Wearing the brace directly against the skin increases risk of skin irritation and pressure injury, especially over bony prominences. Continuous friction and moisture accumulation can lead to breakdown, discomfort, and reduced compliance with long-term brace therapy.
D. The brace should be worn over a fitted t-shirt to protect the skin from direct contact with rigid plastic components, reducing friction and pressure injury risk. A snug cotton layer also improves comfort, enhances adherence, and allows early detection of skin breakdown during routine inspection.
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