Purulent drainage, increasing redness, or fever at a pin site signals infection and must be reported.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A client in skeletal traction asks the nurse to remove the weights to make repositioning more comfortable. What is the nurse's BEST response?
Answer: B. Skeletal traction must be continuous; the weights provide the pulling force that maintains bone alignment and must never be removed or rested on the bed by the nurse. Lifting the weights eliminates the therapeutic force. The other statements either undermine the prescription or imply the weights may be removed.
Question 2 of 5
Caring for a client in skeletal traction, the nurse:
Answer: B. Maintain the line of pull with weights hanging freely (never lift or remove them), keep the client in alignment, perform pin-site care, and assess neurovascular status. Removing the weights disrupts therapy.
Question 3 of 5
A client with a hip fracture in Buck's traction needs care. The nurse:
Answer: B. Maintain proper alignment with weights hanging freely (never lift/remove), assess neurovascular status and skin, manage pain, and prevent immobility complications. Resting the weights on the bed/floor disrupts traction.
Question 4 of 5
A client is using nonpharmacologic measures along with prescribed analgesics. Which nonpharmacologic intervention is appropriate for the nurse to encourage?
Answer: A. Nonpharmacologic strategies such as guided imagery, relaxation breathing, distraction, repositioning, and heat or cold complement analgesics and can reduce the perception of pain. They are used in addition to, not instead of, prescribed medication.
Question 5 of 5
A nurse is assisting an older adult with dementia at mealtime. The client is easily distracted and eats very little. Which intervention promotes adequate intake?
Answer: B. Serving one food item at a time in a quiet, low-distraction setting helps the client with dementia focus and complete the meal. Large varied trays, time pressure, and full feeding when the client can self-feed reduce intake and independence.
Keep the streak going with more questions like these, each with a full rationale.
What is skeletal traction?
Unlike skin traction, it uses heavier weights and is maintained continuously. The nurse must protect pin sites from infection and ensure the traction setup stays effective and uninterrupted.
Key points to remember
- Weights must hang freely and never rest on the floor or be removed without a provider's order.
- Skeletal traction is continuous; skin (Buck's) traction can be intermittent and uses lighter weights.
- Pin sites are a direct portal for infection and a leading source of osteomyelitis.
- Ropes must move freely over pulleys and be aligned with the long axis of the bone.
- Maintaining proper body alignment is essential for the traction to work correctly.
- Prolonged immobility raises the risk of pressure injury, DVT, pneumonia, and constipation.
Nursing priorities
- Ensure weights hang freely off the floor and never lift or remove them without an order.
- Provide pin site care with aseptic technique and assess for signs of infection.
- Perform regular neurovascular checks distal to the fracture.
- Maintain proper body alignment and keep ropes and pulleys functioning freely.
- Prevent immobility complications with skin care, repositioning of unaffected areas, and DVT prophylaxis.
Labs & values
Patient teaching
- Do not adjust or lift the weights or change your position in a way that misaligns the traction.
- Report any drainage, redness, or increased pain at the pin sites or new numbness or tingling.
- Perform deep breathing and ankle exercises in the unaffected leg to prevent complications.
Red flags: report now
- Purulent drainage, increasing redness, or fever at a pin site signals infection and must be reported.
- Loss of distal pulse, numbness, or increasing pain indicates neurovascular compromise; act immediately.
- Never remove the traction weights or let them rest on the bed or floor, as this disrupts alignment.
References
Clinical references for this topic
