The primary health care provider prescribes methotrexate for a client with a new diagnosis of rheumatoid arthritis. The nurse provides health teaching about the drug. What statement by the nurse is appropriate to include about methotrexate?

Choice A reason: Positioning with hips flexed at 90 degrees is inappropriate for Buck’s traction, which is a skin traction applied to the lower leg to align fractures. Excessive hip flexion can disrupt traction alignment and increase discomfort or complications.
Choice B reason: Weights in Buck’s traction must hang freely to maintain constant force for fracture alignment. Contact with the floor negates the traction’s effect, risking bone misalignment and delayed healing, making this an incorrect care practice.
Choice C reason: Checking for skin irritation is critical in Buck’s traction, as prolonged pressure from straps or bandages can cause pressure ulcers or skin breakdown. Regular skin assessment ensures early detection and prevention of complications, maintaining the traction’s safety and efficacy.
Choice D reason: Releasing weights disrupts the continuous force needed for fracture alignment in Buck’s traction. This can lead to bone displacement, increased pain, or delayed healing, making scheduled weight release an inappropriate and harmful practice.

Choice A reason: Cool compresses may provide comfort but are not a primary treatment for acute conjunctivitis, which is often bacterial or viral. They do not address infection or drainage, the main concerns, and are less critical than proper hygiene techniques.
Choice B reason: Topical steroids are not routinely used for acute conjunctivitis, especially bacterial or viral, as they may worsen infections or delay healing by suppressing immune responses. Antibiotics or antivirals are preferred, making this an incorrect teaching point.
Choice C reason: Clearing drainage from the inner to outer aspect of the eye prevents spreading infection across the eye or to the other eye. This technique maintains hygiene, reducing bacterial or viral load in conjunctivitis, making it the most appropriate instruction.
Choice D reason: Patching the eye is not recommended, as it creates a moist environment that can promote bacterial growth or prolong viral conjunctivitis. It may also cause discomfort and is not a standard management strategy for acute conjunctivitis.