A nurse is caring for a client who has a femur fracture with the leg in Buck’s traction. Which of the following actions should the nurse take?
A.
Remove the weights for 20 min for the client’s report of severe pain.
B.
Position the knot of the rope at the top of the pulley
C.
Apply 6.8 kg (15 lb) of weight for use in traction
D.
Compare bilateral pedal pulses.
The correct answer and Explanation is :
The correct answer is:
D. Compare bilateral pedal pulses.
Explanation:
Buck’s traction is a type of skin traction commonly used for patients with hip fractures, femur fractures, or to alleviate muscle spasms. It is a temporary method of immobilizing the limb until definitive surgical treatment can be performed. The purpose is to reduce pain, align the limb, and minimize muscle spasms by applying a pulling force with weights attached via a pulley system.
Key elements in the care of a patient in Buck’s traction include:
- Maintaining proper alignment: The leg must remain in a straight position to ensure the traction is effective. Nurses must frequently assess the positioning and alignment of the affected extremity to prevent complications like malalignment or injury.
- Monitoring neurovascular status: Checking for the adequacy of blood flow to the affected extremity is critical in preventing complications like compartment syndrome, a condition where pressure buildup in a limb can reduce blood flow, leading to tissue death. Comparing bilateral pedal pulses (D) is part of this neurovascular assessment. The nurse compares the strength, rate, and quality of the pulse in both feet to detect any compromise in circulation in the affected leg. Other signs of neurovascular compromise include coldness, pallor, paresthesia, paralysis, and pain.
- Weight management: The weights should not be adjusted without a provider’s order. Removing the weights for pain relief (A) is incorrect because it can disrupt the alignment and effectiveness of the traction. If the patient is experiencing severe pain, it could indicate a complication that should be assessed by the provider.
- Proper pulley setup: The pulley system should remain unobstructed, and the rope should move freely. Option (B) is incorrect because the knot should not rest at the top of the pulley, as it could interfere with traction effectiveness.
- Weight recommendations: The weight for Buck’s traction typically ranges between 2-5 kg (5-10 lbs). Option (C) is incorrect because 6.8 kg (15 lbs) is too much weight for Buck’s traction and may cause excessive pressure on the skin.
By focusing on neurovascular checks, such as comparing pedal pulses (D), the nurse ensures that the traction is not compromising circulation, which is crucial for the patient’s recovery.