On entering the room of a child in Buck’s traction, the nurse makes all of the following observations. Which observation requires a nursing intervention?

Choice A reason: Heels against the bed in Buck’s traction cause pressure, risking skin breakdown or ulcers, especially in children with sensitive skin. This requires intervention (e.g., repositioning or padding) to prevent tissue damage and ensure traction maintains fracture alignment without complications.
Choice B reason: Elevating the head of the bed 20 degrees is acceptable in Buck’s traction, as it promotes comfort and does not disrupt the traction’s alignment or force. It is not a concern requiring intervention unless it affects traction mechanics.
Choice C reason: Freely hanging weights are correct in Buck’s traction, ensuring consistent force to align the fracture. This is a desired observation, as obstructed weights would disrupt traction efficacy, and no intervention is needed for this finding.
Choice D reason: Ropes on pulleys are essential for Buck’s traction to function, allowing smooth force transmission to align the fracture. This is a correct setup, requiring no intervention, as it ensures the traction system operates effectively without mechanical issues.

Choice A reason: Carbidopa does not allow larger levodopa doses but reduces the dose needed by preventing peripheral breakdown. This increases levodopa’s availability to cross the blood-brain barrier, improving efficacy without increasing side effects like nausea from peripheral dopamine.
Choice B reason: Carbidopa inhibits peripheral dopa decarboxylase, preventing levodopa’s conversion to dopamine outside the brain. This increases levodopa’s central nervous system availability, enhancing dopamine production in the basal ganglia to alleviate Parkinson’s symptoms, making it the primary reason for the combination.
Choice C reason: Drug-food interactions (e.g., protein competing with levodopa absorption) persist with levodopa-carbidopa, as carbidopa does not affect intestinal absorption. This is not the primary reason for the combination, which focuses on peripheral metabolism inhibition.
Choice D reason: Carbidopa is not a dopamine precursor and cannot cross the blood-brain barrier. Levodopa is the precursor, converted to dopamine in the brain. Carbidopa’s role is to block peripheral conversion, not to act as a precursor itself.