Case Study: Traction

Mrs. Minor, age 83, fell in the bathroom at the local nursing home.  She is admitted to the hospital with a suspected hip fraction.  She is stabilized in the emergency room, place in bucks traction and sent to the floor until surgery can be performed in the morning.

1.	The rationale for using Bucks Traction is:
A.	To immobilize the extremity
B.	To help control pain.
C.	To prevent further injury.
D.	All the above

2.	The order on the chart states to attach Bucks traction to the right lower extremity with 50# of weight.  the most appropriate action by the nurse is:
A.	Call the orthopedic tech to set up the traction.
B.	Set up the traction as ordered.
C.	Give pain medication before setting up the traction.
D.	Call the physician to clarify the order.

3.	After the traction is set up the nurse will assess all the equipment as well as the patient.  Which of the following is most important in terms of assessment?
A.	Assess neurological status
B.	Assess neurovascular status
C.	Assess breath sounds
D.	Assess urine output

4.	The following morning, Mrs. Minor has the fracture treated by open reduction and internal fixation under a general anesthesia.  Postoperative complication might include:
A.	Paralytic ileus
B.	Change in orientation
C.	Fluid and electrolyte imbalance
D.	Thromboembolism
E.	All the above

5.	Following the surgery, the most important nursing observation include looking for:
A.	Impaired skin integrity
B.	Signs of confusion
C.	Signs of compromised circulation
D.	Problems with the traction

6.	On the second postoperative day. Mrs. Minor complains of a headache.  She is lethargic and confused.  During a careful assessment, the nurse note tachycardia, tachypnea, and dyspnea.  The nurse suspects:
A.	Pneumonia
B.	Fat embolism
C.	Pneumothorax
D.	Heart failure

7.	Arterial Blood gases are pH 7.38, PaO2 85%, PaCO2 48%, HOC3 22.  the nurse would anticipate.
A.	Administering oxygen via nasal cannula.
B.	Administering oxygen via mask, suctioning.
C.	Have the patient cough and deep breath every four hours.
D.	Mechanical ventilation with PEEP

Mrs. Minor improves and is discharged to an extended care facility.