The practical nurse (PN) is caring for a client with pyelonephritis who is admitted for parenteral anti-infective therapy. Prior to discharge home with an oral medication regimen, which instruction is most important for the practical nurse (PN) to reinforce with the client?

Choice A reason: Having someone hold the weights up during transport is not recommended. Buck's traction relies on the consistent pull of the weights to maintain the proper alignment of the fracture. Holding the weights during transport would disrupt the continuous traction and could cause misalignment or exacerbate the injury. It is crucial to maintain the integrity of the traction system during transport.
Choice B reason: Preventing movement of the weights by resting them on top of the bed until the transport is completed is also not advisable. This action would negate the purpose of the traction by removing the continuous pull required to keep the fracture immobilized. Resting the weights on the bed would result in a loss of traction, potentially leading to complications in the healing process.
Choice C reason: Releasing the weights during transport and reconnecting them when the transport is completed is not appropriate. Temporarily removing the traction could cause significant discomfort to the client and disturb the alignment of the fracture. The stability provided by continuous traction is essential for the proper healing of the fracture, and interruptions can lead to adverse outcomes.
Choice D reason: Leaving the weights in place during transport is the best practice. Buck's traction is designed to provide a consistent and gentle pulling force to maintain the alignment of the fracture. The weights should remain in place to ensure the traction is effective throughout the transport process. Proper care should be taken to handle the traction system carefully and avoid any jarring movements that could impact the client's condition.

Choice A reason: Initiating contact isolation precautions is not necessary for psoriasis. Psoriasis is a non-infectious and non-contagious chronic skin condition, so isolating the client would not be appropriate. The main focus should be on managing the symptoms and providing the client with strategies to alleviate their discomfort and improve their quality of life.
Choice B reason: Explaining the need to keep the affected areas dry is not suitable for managing psoriasis. In fact, keeping the skin hydrated is crucial in managing psoriasis symptoms. Dry skin can exacerbate the condition, leading to increased flaking, itching, and discomfort. The practical nurse should educate the client on proper skin care, including using moisturizers to keep the skin hydrated and avoiding harsh soaps and hot water.
Choice C reason: Preparing the client for allergen testing is not relevant in the context of psoriasis. Psoriasis is an autoimmune condition, not an allergic reaction, so allergen testing would not provide useful information for managing the condition. The focus should be on identifying and managing triggers that can exacerbate psoriasis, such as stress, infections, and certain medications.
Choice D reason: Reviewing stress reduction strategies with the client is the most appropriate action. Stress is a known trigger for psoriasis flare-ups, and helping the client develop effective stress management techniques can significantly improve their symptoms. Techniques such as mindfulness, relaxation exercises, and counseling can be beneficial in reducing stress and minimizing psoriasis symptoms. Educating the client on the importance of stress management and providing them with practical strategies can empower them to better manage their condition.