A 10-year-old has 5 lb (2.27 kg) of Buck’s extension traction on his left leg. The nurse should assess the child for which of the following? Select all that apply.
Dryness of the skin, by removing the foam wraps and boot.
Alignment of the shoulder, hips, and knees.
Frayed rope near pulleys.
Correct amount of traction weight on fracture.
Pressure on the coccyx.
The Correct Answer and Explanation is:
Correct answers:
- ✅ Alignment of the shoulder, hips, and knees
- ✅ Frayed rope near pulleys
- ✅ Correct amount of traction weight on fracture
- ✅ Pressure on the coccyx
Explanation
Buck’s extension traction is a type of skin traction used to treat fractures or orthopedic conditions by applying a straight pulling force to align bones and relieve muscle spasms. In pediatric patients, especially a 10-year-old with a femur fracture, it’s essential to monitor for complications and ensure the traction setup is working correctly and safely.
- Alignment of the shoulder, hips, and knees:
Proper body alignment is crucial to ensure effective traction and prevent complications such as muscle contractures or misalignment of the fracture. The nurse should check that the child’s body remains in a straight line, with shoulders, hips, and knees aligned. - Frayed rope near pulleys:
Traction systems rely on smooth, intact ropes for consistent force. Frayed ropes can weaken and may break, posing a safety hazard. Additionally, damaged ropes can cause uneven traction force, compromising the therapeutic effect. - Correct amount of traction weight on fracture:
Traction weight must be accurate. Too much weight can cause excessive pull and damage to soft tissues, while too little may not achieve proper alignment. The nurse must verify the prescribed 5 lb (2.27 kg) is in place and functioning correctly. - Pressure on the coccyx:
Prolonged immobility in traction can lead to pressure injuries, especially on bony prominences like the coccyx. Regular skin assessments and repositioning (as allowed) are essential to prevent pressure ulcers.
Incorrect option:
- ❌ Dryness of the skin, by removing the foam wraps and boot:
This action is inappropriate without specific medical orders. Removing the traction boot or foam wrap can disrupt the setup and reduce the effectiveness of the traction. Skin should be assessed for integrity and signs of irritation, but this is typically done without fully removing the traction device unless ordered.
In summary, the nurse must monitor the traction setup, skin integrity, and body alignment to prevent complications and ensure effective treatment.
