The client in balanced suspension traction is transported to surgery for closed reduction and internal fixation of his fractured femur. Which of the following should the nurse do when transporting the client to the operating room?
- Transfer the client to a cart with manually suspended traction.
- Call the surgeon to request an order to temporarily remove the traction.
- Send the client on his bed with extra help to stabilize the traction.
- Remove the traction and send the client on a cart.
Q19 A client is in balanced suspension traction using a half-ring Thomas splint with a Pearson attachment that suspends the lower extremity and applies direct skeletal traction for a hip fracture. Which of the following nursing assessments would not be appropriate?
- Greater trochanter skin checks.
- Pin site inspection.
- Neurovascular checks proximal to the splint.
- Foot movement evaluation.68:
The Correct Answer and Explanation is :
For the first question (transporting the client to surgery for closed reduction and internal fixation of a fractured femur):
The correct answer is: 3. Send the client on his bed with extra help to stabilize the traction.
Explanation:
In balanced suspension traction, the traction apparatus is designed to keep the limb in the correct alignment, preventing further injury and minimizing pain. When a client is being transported to the operating room for surgery, it is important to ensure that the traction is maintained during transport. Removing the traction or transferring the client in a way that disrupts the alignment of the leg can cause significant harm or discomfort.
Option 1 (manually suspended traction) is not ideal, as it would likely be less stable and could place unnecessary strain on the client. Option 2 (calling the surgeon to request an order to temporarily remove the traction) is generally not recommended, as removal of the traction could result in improper alignment or re-injury before surgery. Option 4 (removing the traction entirely) could lead to further instability and possible complications. Therefore, the best approach is to maintain the traction on the bed and ensure that extra help is available to stabilize the traction while the client is being moved.
For the second question (nursing assessment for a client in balanced suspension traction using a half-ring Thomas splint with a Pearson attachment for a hip fracture):
The correct answer is: 3. Neurovascular checks proximal to the splint.
Explanation:
Balanced suspension traction using a half-ring Thomas splint with a Pearson attachment is designed to apply skeletal traction to the femur, maintaining alignment and stabilizing the hip fracture. The focus of nursing assessments should be on areas that are affected by the traction or the fracture.
- Option 1 (Greater trochanter skin checks): This is an appropriate assessment, as it checks for pressure sores or other skin issues on the areas where the splint and traction are applied.
- Option 2 (Pin site inspection): This is also important because infection at the pin site can occur when skeletal traction is used. It’s essential to inspect and clean the pin sites to prevent complications.
- Option 3 (Neurovascular checks proximal to the splint): This is NOT appropriate because the neurovascular checks should be focused on the distal areas of the limb (the foot and lower leg) to assess for circulation, sensation, and movement, which could be affected by the traction. Proximal checks may not provide information relevant to the condition of the limb being treated.
- Option 4 (Foot movement evaluation): This is an appropriate assessment, as it helps ensure that the nerves and muscles distal to the fracture are functioning and that circulation is intact.
By focusing on the appropriate areas (distal to the splint) and regularly checking for complications related to the traction and fracture, the nurse can ensure optimal care and prevent further complications.