The nurse is providing discharge education to a patient with skin traction. Which instruction should the nurse include?
"Avoid any weight-bearing activities for the duration of traction."
"You may remove the traction device at night for more comfort."
"Clean the skin under the traction tape with alcohol wipes daily."
"Report any signs of skin redness or irritation to your healthcare provider."
The Correct Answer is D
Option D is the correct instruction because the patient should be vigilant in monitoring for any signs of skin redness, irritation, or discomfort under the traction tape. Promptly reporting these symptoms to the healthcare provider allows for early intervention and prevention of skin complications.
a. "Avoid any weight-bearing activities for the duration of traction" is incorrect because weight-bearing activities are typically restricted only in certain types of traction, such as skeletal traction. The nurse should specify any activity restrictions based on the type of traction provided to the patient.
b. "You may remove the traction device at night for more comfort" is incorrect. Skin traction is a continuous intervention, and removing the device can compromise its effectiveness in providing traction and immobilizing the affected limb.
c. "Clean the skin under the traction tape with alcohol wipes daily" is incorrect. Alcohol wipes can cause skin dryness and irritation, which may exacerbate skin issues under the traction tape. The nurse should recommend gentle cleaning and moisturizing as needed.
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Related Questions
Correct Answer is C
Explanation
The patient being unable to move the affected limb in skin traction requires further assessment. Traction should allow some degree of movement, and the nurse should investigate the cause of the restricted motion and take appropriate action.
a. The patient being able to perform active range of motion exercises indicates that some mobility is possible with the traction, which is a positive finding.
b. The patient experiencing some discomfort during range of motion exercises is not unexpected, as traction may cause some discomfort due to realignment of the bone.
d. The patient having difficulty moving the affected limb may be expected with skin traction, and the nurse should continue to monitor the patient's progress.
Correct Answer is D
Explanation
Engaging in regular communication to discuss the patient's progress demonstrates effective nursing collaboration. This allows the nurse and physical therapist to coordinate care, make adjustments to the treatment plan, and ensure the best possible outcomes for the patient.
a. Taking over the physical therapist's treatment plan without discussion is not collaborative and can lead to misunderstandings and conflicts between the nurse and the physical therapist.
b. Providing the physical therapist with outdated patient information can compromise the patient's care and is not conducive to effective collaboration.
c. Scheduling therapy sessions at a convenient time for the nurse disregards the needs and progress of the patient, which is not a collaborative approach.
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