A child admitted with a fracture of the femur and placed in skeletal traction. What should the nurse assess first?

A child admitted with a fracture of the femur and placed in skeletal traction. What should the nurse assess first?

• A. The pull of traction on the pin
• B. The Ace bandage
• C. The pin sites for signs of infection
• D. The dressings for tightness

Answer: (A)

The key idea here is that skeletal traction must deliver a continuous, unobstructed pulling force to realign the fracture. The first thing to assess is the pull of traction on the pin, because if the traction is not being applied correctly—weights not hanging freely, rope kinked or pulled off the pulley, or misalignment—the fracture won’t be adequately supported and serious complications like malalignment or neurovascular compromise can occur. So the nurse should verify that the traction pull is intact and the setup is functioning as intended before attending to other aspects. After confirming the pull, you would monitor distal neurovascular status and then assess pin sites, dressings, and the dressing/tape around the limb to ensure none are compromising circulation or traction.

The key idea here is that skeletal traction must deliver a continuous, unobstructed pulling force to realign the fracture. The first thing to assess is the pull of traction on the pin, because if the traction is not being applied correctly—weights not hanging freely, rope kinked or pulled off the pulley, or misalignment—the fracture won’t be adequately supported and serious complications like malalignment or neurovascular compromise can occur. So the nurse should verify that the traction pull is intact and the setup is functioning as intended before attending to other aspects. After confirming the pull, you would monitor distal neurovascular status and then assess pin sites, dressings, and the dressing/tape around the limb to ensure none are compromising circulation or traction.