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Difficulty: HardErgonomics and Safe Use of Equipment

A practical nurse (PN) is caring for a client with a right fractured femur who is placed in Buck's skin traction. Upon entering the room, the PN notes that the client has slid down toward the foot of the bed, causing the traction weights to rest against the bed frame. Which action by the PN demonstrates correct ergonomic principles and safe use of traction equipment?

  1. Lower the head of the bed flat, request assistance from a colleague, and use a draw sheet to slide the client upward while they pull on the overhead trapeze.Answer
  2. B
    Manually lift and hold the traction weights to release tension on the affected leg while pulling the client upward from under their axillae.
  3. C
    Delegate the task of repositioning the client to an unlicensed assistive personnel (UAP) to quickly restore the free-hanging position of the weights.
  4. D
    Elevate the head of the bed to a high-Fowler's position and instruct the client to use their unaffected leg to push themselves upward.

Answer

The correct action is to lower the head of the bed flat, get assistance from another staff member, and use a draw sheet in combination with the client using an overhead trapeze to move upward.
Moving a client in traction requires strict adherence to both ergonomic principles and equipment safety rules. Lowering the bed flat works with gravity rather than against it, reducing strain. Using a draw sheet with a colleague's assistance minimizes shear forces on the client's skin and protects the nurses' backs. Having the client use an overhead trapeze maximizes client participation. Throughout this safe movement, the continuous line of pull from the traction is maintained.

Step-by-Step Solution

1
Assess the equipment and client alignment.
Identified that the traction weights are resting on the bed frame, rendering the traction ineffective.
Weights must hang freely to provide the continuous pull required to relieve muscle spasms and maintain alignment of the fractured femur.
2
Determine the safest ergonomic method to reposition the client.
Planned to lower the bed, use a draw sheet, involve a second staff member, and utilize the overhead trapeze.
Lowering the bed removes the force of gravity working against the transfer. The draw sheet reduces friction, the second staff member divides the physical load, and the trapeze utilizes the client's upper body strength, protecting the nurse's back.
3
Execute the repositioning without interrupting the traction.
The client is moved up in bed while the weights remain attached and unsupported by staff.
Traction must be continuous. Lifting or removing the weights disrupts the therapeutic pull and can cause severe muscle spasms or misalignment of the fracture.

Key Concept

Ergonomic principles in patient repositioning and safe maintenance of orthopedic traction equipment.
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Topics

Ergonomics and Safe Use of Equipment

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