The nurse is assessing a patient with skin traction for any potential complications. Which finding requires immediate intervention?

Purplish discoloration below the traction site may indicate impaired circulation, and it requires immediate intervention to prevent further complications like pressure ulcers or nerve damage.

a. Mild redness around the traction tape is common and may be expected, but it does not require immediate intervention unless it worsens or is accompanied by other signs of infection.

b. Slight discomfort at the traction site is expected as a result of the applied tension, and it can be managed with appropriate pain management techniques.

c. Skin irritation from the adhesive strips can be addressed by repositioning the strips or using appropriate skin protection measures.

Option A is appropriate because assessing the skin under the traction tape helps monitor for any signs of skin breakdown, irritation, or pressure ulcers. Regular skin assessments are essential to prevent complications related to skin traction.

b. Tightening the traction ropes to increase the traction force is incorrect. The traction force should be set by the healthcare provider, and altering it without proper authorization may lead to adverse effects or further injury.

c. Placing the traction weights on the bed instead of suspending them is incorrect. Traction weights should be suspended freely to provide the appropriate traction force and maintain proper alignment of the fractured bone.