The nurse is preparing for a blood transfusion. Which of the following would be contraindicated to include in the prep for the procedure?

A) Remove the traction when the client wants to ambulate:
Traction is a therapeutic treatment used to immobilize bones, joints, or soft tissues, often after fractures or orthopedic procedures. Removing traction to allow ambulation is not appropriate unless directed by a healthcare provider. Traction must be maintained to ensure proper alignment and healing of the affected body part. Premature removal can cause complications such as malalignment, delayed healing, or further injury.

B) Provide pin site care for skin traction:
Pin site care is required for skeletal traction, not skin traction. Skin traction uses adhesive strips or other external devices to apply force to the body, and no pins are involved. Skeletal traction, on the other hand, uses pins, screws, or wires that are inserted directly into the bone. It’s important to provide proper pin site care to prevent infection in skeletal traction, but this is not relevant to skin traction, which doesn’t involve direct penetration of the skin.

C) Check the weights to ensure that they are hanging freely:
It is essential to check that the weights in traction are hanging freely and not in contact with the floor or any other surface. Weights should be unobstructed to provide continuous, even force that maintains the proper alignment of the injured body part. Any obstruction or improper positioning of the weights can compromise the effectiveness of the traction and delay healing.

D) Adjust the amount of weight depending on the client’s preference:
The amount of weight used in traction is determined by the healthcare provider based on the specific injury or condition being treated. Adjusting the weight based on the client's preference could lead to inappropriate tension, worsening the injury or hindering the healing process. The nurse should not adjust the weight without a physician’s order, as it is critical to follow the prescribed treatment plan for optimal healing and safety.

A) "Be sure to bend at the hip, not the knee, to pick up items."
After hip replacement surgery, patients are instructed to avoid bending at the hip beyond 90 degrees, as this can dislocate the newly replaced hip. The correct guidance would be to avoid bending at the hip and instead bend at the knee when picking up items, ensuring the hip joint stays in a safe position.

B) "Internally rotating your leg is okay, but do not externally rotate it."
Internal rotation of the hip joint should also be avoided post-surgery, as it can increase the risk of dislocation. The correct teaching is to prevent both internal and external rotation of the hip to ensure the joint remains stable. Patients should be instructed to avoid twisting motions that can compromise the surgical repair.

C) "If we need to help you roll in bed, we will roll you towards the operative side."
This can place undue pressure on the newly replaced hip, potentially leading to dislocation or injury. The operative side should be kept stable and protected, so it is safer to roll the patient onto the non-operative side if necessary.

D) "You should keep your knees apart using a wedge or pillow."
It is essential to keep the knees apart, typically using a wedge or pillow between the legs. This prevents the hip from adducting (moving toward the midline) and reducing the risk of dislocation. Maintaining this position ensures the hip remains in a safe, stable alignment during the healing process.