The nurse explains that Bryant's traction is reserved for children who weigh less than how many pounds?

Choice A reason: Phenytoin can be taken with or without food, as food does not significantly affect its absorption. Taking it on an empty stomach is not necessary and may cause gastrointestinal upset, making this an incorrect teaching point for long-term use.
Choice B reason: Insomnia is not a common side effect of phenytoin. Common neurological effects include dizziness, ataxia, or sedation due to its action on sodium channels, stabilizing neuronal membranes. Teaching about insomnia is irrelevant and does not address key management concerns.
Choice C reason: Phenytoin commonly causes gingival hyperplasia due to fibroblast proliferation in gum tissue. Regular gum massage and good oral hygiene can reduce this risk by promoting circulation and preventing tissue overgrowth, making this a critical teaching point for long-term use.
Choice D reason: Blood pressure monitoring is not a primary concern with phenytoin, which primarily affects the central nervous system and liver. While rare cardiovascular effects may occur, gingival hyperplasia and blood level monitoring are more significant for long-term management.

Choice A reason: Frequent neurovascular checks (pulse, sensation, movement) in Bryant’s traction, used for pediatric femur fractures, detect early signs of compartment syndrome or vascular compromise. This prevents complications like tissue ischemia or nerve damage, critical due to traction’s pressure on soft tissues.
Choice B reason: Tight bandages in Bryant’s traction can cause skin breakdown or impair circulation, increasing the risk of pressure ulcers or compartment syndrome. Bandages should be snug but not constrictive to maintain skin integrity and ensure proper traction function.
Choice C reason: Restraining a child from rolling over may prevent traction disruption but increases the risk of pressure ulcers and discomfort. Controlled movement within traction limits is allowed, and restraint does not directly address neurovascular or circulatory complications.
Choice D reason: The child’s buttocks should be slightly elevated in Bryant’s traction to maintain proper alignment and traction force. Resting on the bed negates the traction’s effect, risking bone misalignment and delayed healing, increasing complication risks.