Chapter 11: Orthopedic Measures Nursing School Test Banks

MULTIPLE CHOICE

1. According to the National Association of Orthopaedic Nurses (NAON), which of the following is possibly the most effective cleansing solution for pin-site care?

a.

Normal saline

b.

Hydrogen peroxide

c.

Chlorhexidine

d.

None of the above

ANS: C

The second group to develop clinical practice guidelines is the United Statesbased NAON, which indicated that chlorhexidine 2 mg/mL solution is possibly the most effective cleansing solution for pin-site care. A British consensus group of orthopedic nurse experts recommends that pin sites be cleaned only with sterile normal saline or water to remove crusts around the pins (Walker, 2007). Walker found no definitive evidence to support a pin-site dressing containing an antimicrobial agent. Several studies have found that although hydrogen peroxide is a common cleansing agent, it may cause damage to the healthy tissue surrounding the pin.

DIF: Cognitive Level: Comprehension REF: Text reference: p. 264

OBJ: Explain nursing measures for complications from traction.

TOP: Pin-Site Care KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

2. The patient has a broken leg and needs to have a cast applied. When plaster of Paris is compared and contrasted versus the newer synthetic casts, which of the following statements is true?

a.

Plaster of Paris can tolerate earlier weight bearing than synthetic casts.

b.

Plaster of Paris is more expensive than synthetic casts.

c.

Synthetic casts can withstand contact with water better than plaster of Paris.

d.

Synthetic casts are lighter but take longer to set than plaster of Paris.

ANS: C

Although the newer synthetic casts are more expensive than plaster of Paris, they can withstand contact with water without crumbling. A plaster of Paris cast has multiple rolls of open-weave cotton saturated with calcium sulfate crystals. These casts are heavier than synthetic casts and take 24 to 72 hours with no weight bearing or application of pressure while drying. Synthetic casts are lightweight, set in 15 minutes, and can sustain weight bearing or pressure in 15 to 30 minutes.

DIF: Cognitive Level: Analysis REF: Text reference: p. 251

OBJ: Explain nursing measures for complications from traction.

TOP: Comparison of Cast Material KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity

3. An expected outcome of cast application that the nurse evaluates is:

a.

skin irritation at the cast edges.

b.

decreased capillary refill and pallor.

c.

tingling and numbness distal to the cast.

d.

slight edema, soreness, and limited range of motion.

ANS: D

Expected outcomes after completion of the procedure: Patient initially experiences only slight edema, soreness, mild pain, and some limitation of active range of joint motion (ROJM) from being in the cast. Expected outcomes after completion of the procedure: Skin around proximal and distal cast edges remains intact without irritation, is free of pressure and friction from the cast edges, and is warm and of normal color with capillary refill of 3 seconds or less; and the patient verbalizes no abnormal or unusual sensations and is able to move the fingers or toes below the casted part. Neurovascular function to the body part is maintained.

DIF: Cognitive Level: Application REF: Text reference: p. 252

OBJ: Describe neurovascular assessments of a patient with an orthopedic injury.

TOP: Expected Outcomes KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity

4. The patient is admitted for a fractured tibia. The nurse is preparing for cast application and expects to administer a(n) _____ to the patient minutes before the procedure.

a.

oral analgesic 10

b.

intramuscular (IM) analgesic 10

c.

intravenous (IV) analgesic 2 to 5

d.

muscle relaxant 10

ANS: C

Administer analgesic per order before cast application: IV, 2 to 5 minutes before the procedure. This is the most effective way to reduce pain during cast application.

Alternately, you could administer analgesic by mouth (PO), 30 to 40 minutes before cast application to obtain optimal analgesic effect. If administering analgesic via IM injection, give does 20 to 30 minutes before cast application for optimal analgesic effect. Administer muscle relaxant 30 minutes before cast application if spasms are present. Often, muscle spasms are treated more effectively with skeletal muscle relaxants than with opioids.

DIF: Cognitive Level: Application REF: Text reference: p. 252

OBJ: Describe how to assist in application of casts. TOP: Preprocedure Medication

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

5. An appropriate technique for the nurse to implement for the patient who is being casted is to:

a.

apply ice to the top of the cast.

b.

maintain the extremity below heart level.

c.

handle the wet cast with the fingertips.

d.

fold the stockinette or padding over the outer cast edges.

ANS: D

Assist with finishing by folding the stockinette or other padding down over the outer edge of the cast to provide a smooth edge. Smooth edges lessen possible skin irritation. When the cast is finished with a stockinette, later petaling with tape is not required when the cast is dry. Elevation and ice can be ordered, but ice would not be applied to the top of the wet cast because the weight could change the shape of the cast, causing indentations that can lead to pressure areas. Maintain elevation at or above heart level; elevation enhances venous return and decreases edema. Handle the casted extremity with palms only until the cast is dry. Fingers can cause indentations that can lead to pressure areas.

DIF: Cognitive Level: Application REF: Text reference: p. 254

OBJ: Describe how to assist in application of casts. TOP: Finishing the Cast

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

6. When teaching cast care, the nurse instructs the patient to:

a.

blow dry the wet cast on the hot setting.

b.

report changes in sensation or mobility to the area.

c.

use only soft objects to slide down the cast for scratching.

d.

cut away the edges of the cast if the skin becomes irritated.

ANS: B

The patient must monitor neurovascular status, paying particular attention to blueness or paleness of the nails, pain, a feeling of tightness, numbness, or a tingling sensation. Caution the patient against drying a wet cast with a hair dryer; this can cause plaster to crack or the skin underneath to be damaged. The patient should avoid sticking objects down or into the cast to scratch because these objects can cause breaks in underlying skin and subsequent infection. Inform the patient to inspect the cast and petal rough edges to reduce the risk of trauma to underlying skin and the need for cast changes. Small pieces (petals) of adhesive tape 2.5 to 5.0 cm (1 to 2 inches) are cut and taped smoothly over the edge of the cast.

DIF: Cognitive Level: Comprehension REF: Text reference: pp. 254-256

OBJ: Describe elements of education for the patient with a cast and after removal of a cast.

TOP: Cast Care KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity

7. For cast removal, which of the following instructions should the nurse provide to the patient?

a.

Discomfort will be felt from the cast saw.

b.

An enzyme wash may be applied to intact skin.

c.

The skin will be scrubbed very well after the removal.

d.

Aggressive range-of-motion exercises will be performed after removal.

ANS: B

If the skin is intact, gently apply a cold water enzyme wash to the skin; let it stay on the skin 15 to 20 minutes. This helps dissolve or emulsify dead cells and fatty deposits on tissues and prevents injury to delicate tissue. A cast saw vibrates the cast loose; the patient will feel heat and vibration. Do not scrub the skin because this may traumatize delicate tissue and lead to skin breakdown. It may take several days before all residue is removed from the skin. Obtain a physicians order to gently put joints through active and passive ROJM. Clarify the level of activity allowed. Joints and muscles will be stiff and weak. Activity is resumed slowly to avoid reinjury.

DIF: Cognitive Level: Comprehension REF: Text reference: pp. 257-258

OBJ: Describe elements of education for the patient with a cast and after removal of a cast.

TOP: Cast Removal KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

8. The patient is brought into the emergency department after falling on the ice in her driveway. She is suspected of having a fractured hip. After comparing different available types of traction, she anticipates that which of the following will be used?

a.

Bryants traction

b.

Dunlops traction

c.

Bucks extension

d.

Gallows traction

ANS: C

Bucks extension provides temporary immobilization of a hip fracture until open reduction and internal fixation (ORIF) can be performed. It also reduces muscle spasms, contractures, and dislocations and occasionally is used as an interim treatment for lumbosacral muscle spasms that cause low back pain. Bryants traction (called Gallows in England) is no longer used because of the risk for gravitational vascular draining of the extremities and the possible tourniquet effect of bandages, triggering vasospasms and avascular necrosis. Dunlops traction is a simultaneous horizontal form of Bucks extension to the humerus with an accompanying vertical Bucks extension to the forearm.

DIF: Cognitive Level: Analysis REF: Text reference: p. 258

OBJ: Explain the purposes of placing a patient in skin or skeletal traction.

TOP: Bucks Traction KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

9. Which type of traction does the nurse anticipate will be used for an adult patient with a fractured humerus?

a.

Bryants traction

b.

Dunlops traction

c.

Gallows traction

d.

Bucks extension

ANS: B

Dunlops traction is a simultaneous horizontal form of Bucks extension to the humerus with an accompanying vertical Bucks extension to the forearm. Bryants traction (called Gallows in England) is no longer used because of the risk for gravitational vascular draining of the extremities and the possible tourniquet effect of bandages, triggering vasospasms and avascular necrosis. Bucks extension provides temporary immobilization of a hip fracture until ORIF can be performed. It also reduces muscle spasms, contractures, and dislocations and occasionally is used as an interim treatment for lumbosacral muscle spasms that cause low back pain.

DIF: Cognitive Level: Analysis REF: Text reference: p. 258

OBJ: Explain the purposes of placing a patient in skin or skeletal traction.

TOP: Dunlops Traction KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

10. For a patient who is to be placed in Russells traction, the nurse prepares the:

a.

occipital area.

b.

arm and forearm.

c.

back and abdomen.

d.

lower extremities.

ANS: D

Russells traction is a modification of Bucks extension in which Newtons third law of motion (for each force in one direction, there is an equal force in the opposite direction) is used to double the amount of pull through the arrangement of ropes, pulleys, and weights.

DIF: Cognitive Level: Comprehension REF: Text reference: p. 258

OBJ: Explain the purposes of placing a patient in skin or skeletal traction.

TOP: Russells Traction KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

11. The nurse places the patient in traction. Expected outcomes would include which of the following?

a.

Alignment of fracture fragments with formation of callus within 24 hours

b.

Verbalization of pain level as a 4 on a scale of 0 to 10

c.

Verbalization of immediate relief of symptoms

d.

Distal skin tissue becoming cooler, with capillary refill greater than 3 seconds

ANS: B

Expected outcomes would include verbalization of increased comfort after traction application and rating of pain as 4 or lower on a scale of 0 to 10 since injured tissues and bone are stabilized. Evidence of callus may not become apparent for 7 to 10 days or longer. Sufficient time in traction (varying from 1 to 10 or more days) elicits symptom relief. It takes time for inflammation to decrease and tissues to regain more normal function. Neurovascular status should remain stable. Distal skin tissue remains warm and of a normal color with capillary refill of 3 seconds or less.

DIF: Cognitive Level: Comprehension REF: Text reference: pp. 261-262

OBJ: Explain the purposes of placing a patient in skin or skeletal traction.

TOP: Expected Outcomes of Traction KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

12. While in Bucks extension traction, the patient may be positioned on the back:

a.

with the head of the bed elevated 45 degrees.

b.

turning to the unaffected side for 10- to 15-minute periods.

c.

with the buttocks slightly elevated off of the bed.

d.

with the bed tilted toward the side that is opposite the traction.

ANS: B

Position varies with the part of the body to be placed in traction, plus effects of weight and gravity. Body parts are kept aligned anatomically. With Bucks extension, the patient is primarily on his back but may be allowed to turn to the unaffected side for brief periods (10 to 15 minutes). With Bucks extension, the patient is on his back with the head of the bed flat or elevated no more than 30 degrees. With Dunlops traction, the patient may be tilted on low-shock blocks toward the side opposite the traction.

DIF: Cognitive Level: Application REF: Text reference: p. 261

OBJ: Explain the purposes of placing a patient in skin or skeletal traction.

TOP: Positioning KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

13. An appropriate technique for the nurse to implement for a patient who is being placed in traction is to:

a.

apply a traction boot tightly.

b.

drop the weights after the traction is attached.

c.

assess neurovascular status every 1 to 2 hours for the first day.

d.

shave the hair off the area where traction is to be placed.

ANS: C

Assess neurovascular status 15 minutes after application of skin traction and every 1 to 2 hours for 24 hours, and then extend to every 4 hours if the patient is stabilizing. Ensure that boot size is correct. A traction boot should fit snugly (not too tight or too loose). Too tight leads to pressure on skin, peroneal nerve, and vascular structures. When all traction materials and spreader bars are in place, weights are placed on weight holders and are attached to a loop in the rope. The weights then are lowered slowly and gently until the rope is taut. Traction is established slowly to avoid involuntary muscle spasms or pain for the patient. Shaving may create micro nicks that could become inflamed under traction strips.

DIF: Cognitive Level: Application REF: Text reference: pp. 261-262

OBJ: Explain the purposes of placing a patient in skin or skeletal traction.

TOP: Evaluation of Traction KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity

14. For a patient in traction who has skeletal pins, the nurse should:

a.

use povidone-iodine to cleanse the pin site.

b.

apply antiseptic ointment and cover with a split dressing.

c.

use hydrogen peroxide as a rinse before a dressing is applied.

d.

do both pin sites at the same time, with the same swab and solution.

ANS: B

Using a sterile applicator, apply a small amount of topical antibiotic ointment to the pin site and cover with a sterile 2 2 split gauze dressing. (Note: Some physicians leave the site uncovered.) Dip a sterile cotton-tipped applicator into a sterile container of chlorhexidine 2 mg/mL solution. Place a sterile applicator by the pin, and roll it along the skin, away from the insertion site. Clean outward in a circular fashion from the pin. Dispose of the applicator. Remove crusts from the pin site when signs of infection are present. Chlorhexidine 2 mg/mL is the most effective cleansing solution for pin-site care. Never touch one pin site with material used on another. This prevents cross-contamination.

DIF: Cognitive Level: Application REF: Text reference: p. 266

OBJ: Describe steps for applying each form of skin or skeletal traction.

TOP: Pin Care KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

15. For a patient with a fractured femur, a nurse is alert to the possibility of a fat embolus. What should the nurse specifically watch for?

a.

Bradypnea

b.

Restlessness

c.

Bradycardia

d.

Calf pain

ANS: B

Assess for indicators of hypoxemia, such as restlessness or agitation. Recognize early signs of fat embolism syndrome. Signs of hypoxemia include tachypnea, not bradypnea. Signs of hypoxemia include tachycardia, not bradycardia. Calf pain would indicate a DVT, not a fat embolism.

DIF: Cognitive Level: Application REF: Text reference: p. 267

OBJ: Explain nursing measures for complications from traction.

TOP: Fat Embolism Syndrome KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity

16. In planning nursing care, the nurse knows that she will need to provide an abduction pillow for which patient?

a.

A patient who will be immobilized for a long time

b.

A patient who has undergone repair of a fractured right arm

c.

A patient who is post hip replacement surgery

d.

A patient who has a severely sprained ankle

ANS: C

The abduction splint or pillow, used after hip replacement surgery, maintains the patients legs in an abducted position. This permits the patient to be turned without changing the position of the healing limb, and prevents dislocation of the hip prosthesis.

DIF: Cognitive Level: Application REF: Text reference: p. 268

OBJ: Explain nursing measures for complications from immobilization.

TOP: Abduction Pillows KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

MULTIPLE RESPONSE

1. The nurse is caring for a patient who has had a new cast applied. The nurse is performing a neurovascular assessment so as to detect signs of possible compartment syndrome. Which of the following are signs of compartment syndrome? (Select all that apply.)

a.

Inability to move body parts distal to the cast

b.

Pain on passive motion of distal body parts

c.

Hyperventilation

d.

Tachycardia

ANS: A, B, C, D

Signs of development of compartment syndrome, cast syndrome, or severe claustrophobia may result from snugness of the cast, which is common for patients in a spica or body cast. Observe the patient for signs of pain or anxiety; ask the patient to rate pain on a scale from 0 to 10; observe for inability to move body parts distal to the cast, pain on passive motion of distal body parts, hyperventilation, swallowing of air (aerophagia), nausea and/or vomiting, tachycardia, and blood pressure elevation.

DIF: Cognitive Level: Comprehension REF: Text reference: p. 255

OBJ: Describe neurovascular assessments of a patient with an orthopedic injury.

TOP: Compartment Syndrome KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity

2. The patient is in traction and is at risk for fat embolism syndrome. Signs and symptoms of fat embolism include which of the following? (Select all that apply.)

a.

Chest pain

b.

Tachypnea

c.

Tachycardia

d.

Apprehension

e.

Altered LOC

ANS: A, B, C, D

Symptoms of possible fat embolism include clinical manifestations of dyspnea, tachycardia, cyanosis, and circulatory collapse.

DIF: Cognitive Level: Comprehension REF: Text reference: p. 267

OBJ: Explain nursing measures for complications from traction.

TOP: Fat Embolism Syndrome KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity

3. The patient has been in skeletal traction for external fixation of his femur for 2 days. Suddenly, he calls the nurse complaining of chest pain and shortness of breath. The nurse notes that the patient appears anxious, and that his pulse and respirations are elevated. She should do which of the following? (Select all that apply.)

a.

Massage the lower extremity

b.

Elevate the head of the bed

c.

Administer oxygen

d.

Notify the physician

ANS: B, C, D

If symptoms of pulmonary embolus are evident, elevate the head of the bed (if conscious), administer oxygen, and notify the physician immediately. Do not massage the lower extremity.

DIF: Cognitive Level: Application REF: Text reference: p. 267

OBJ: Explain nursing measures for complications from traction.

TOP: Pulmonary Embolism KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

4. Skeletal traction is implemented primarily for: (Select all that apply.)

a.

simple fracture.

b.

multiple trauma.

c.

fractured ankle.

d.

acetabular fracture.

e.

cervical fracture.

ANS: B, C, D, E

Skeletal traction immobilizes fractures of the cervical spine, fractures of the femur below the trochanter, and some fractures of the bones of the arm or ankle. It is also used to immobilize the femoral head in an acetabular fracture.

DIF: Cognitive Level: Comprehension REF: Text reference: p. 263

OBJ: Describe steps for applying each form of skin or skeletal traction.

TOP: Evaluation of Traction KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

COMPLETION

1. __________________ involves monitoring for the five Ps (pain, pallor, pulselessness, paresthesia, and paralysis).

ANS:

Neurovascular assessment

It is essential to monitor for the five Ps (pain, pallor, pulselessness, paresthesia, and paralysis) of neurovascular status because permanent damage may result if circulation is not restored or pressure is not removed.

DIF: Cognitive Level: Comprehension REF: Text reference: p. 256

OBJ: Explain nursing measures for complications from traction.

TOP: Neurovascular Assessment KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

2. The patient has fallen and broken her leg. To keep the leg bones aligned and to reduce muscle spasms, the physician orders the patient to be placed in ____________.

ANS:

Bucks traction

Bucks traction is the most common type of adult skin traction. It is applied to the legs to provide temporary immobilization of the hip while reducing muscle spasms, contractures, and dislocations.

DIF: Cognitive Level: Comprehension REF: Text reference: pp. 258-259

OBJ: Explain nursing measures for complications from traction.

TOP: Traction KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

3. A _______________ is an externally applied structure that holds musculoskeletal tissues in a specific position to permit healing of injuries or fractures or to align malpositioned tissues.

ANS:

cast

A cast is an externally applied structure that holds musculoskeletal tissues in a specific position to permit healing of injuries or fractures or to align malpositioned tissues, as in clubfoot or congenital hip dislocation.

DIF: Cognitive Level: Comprehension REF: Text reference: p. 250

OBJ: Explain nursing measures for complications from traction.

TOP: Cast KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

4. After application of the cast, the nurse ensures that plaster crumbs are removed and rough edges are _________ to prevent skin breakdown.

ANS:

petaled

After application of the cast, ensure that plaster crumbs are removed and rough edges are petaled to prevent skin breakdown.

DIF: Cognitive Level: Comprehension REF: Text reference: p. 254

OBJ: Explain nursing measures for complications from traction.

TOP: Petaling KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

5. When applying a plaster of Paris cast, it is important to keep the cast exposed for at least _____________ minutes.

ANS:

15

fifteen

Explain that the patient may experience warmth during the cast application process. Plaster gives off heat from a chemical reaction when drying. Keep the cast exposed to permit maximum dissipation of the heat. Most casts cool in about 15 minutes.

DIF: Cognitive Level: Comprehension REF: Text reference: p. 253

OBJ: Describe how to assist in application of casts. TOP: Heat Dissipation

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

6. After applying a cast, the nurse should be able to insert _______ fingers between the cast and the limb.

ANS:

2

two

Plaster must be of sufficient thickness to give strength to the cast. More than two fingers space in the cast indicates that the cast is too loose and will not support the limb; less than two fingers space indicates that the cast may be too tight and may inhibit circulation.

DIF: Cognitive Level: Comprehension REF: Text reference: p. 255

OBJ: Describe how to assist in application of casts.

TOP: Spacing Between Cast and Limb KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

7. _________________ may occur when pressure within a casted extremity increases.

ANS:

Compartment syndrome

When pressure within a casted extremity increases, this may lead to compartment syndrome, which occurs when pressure within the muscle compartment increases as a result of edema, bleeding, or decreased venous return. The fascia covering the muscle group acts as a tourniquet on structures within the compartment such as nerves, blood vessels, and muscle tissue.

DIF: Cognitive Level: Comprehension REF: Text reference: p. 255

OBJ: Describe neurovascular assessments of a patient with an orthopedic injury.

TOP: Compartment Syndrome KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Physiological Integrity

8. _____________________ applies a pull indirectly to the bone via straps attached to the skin around the structure.

ANS:

Skin traction

Skin traction applies a pull indirectly to the bone via straps and a sling or boot applied to the skin around the structure. Skin traction typically applies between 5 and 7 lb and is commonly used for minor trauma or immediate immobilization before surgery.

DIF: Cognitive Level: Comprehension REF: Text reference: p. 258

OBJ: Explain the purposes of placing a patient in skin or skeletal traction.

TOP: Skin Traction KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

9. ____________________ consists of a metal frame that secures pins inserted through the bone above and below the fracture site. It stabilizes a fracture with hardware visible outside the body.

ANS:

External fixation

External fixation consists of a metal frame that secures pins inserted through the bone above and below a fracture site. External fixation stabilizes a fracture with hardware visible outside the body. It fosters the healing of complex fractured bones, usually in the lower extremities.

DIF: Cognitive Level: Comprehension REF: Text reference: p. 263

OBJ: Describe steps for applying each form of skin or skeletal traction.

TOP: Evaluation of Traction KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity

10. An immobilization device used to immobilize and protect a body part is known as a ________.

ANS:

splint

Immobilization devices increase stability, support weak extremities, or reduce the load on weight-bearing structures such as hips, knees, or ankles. A splint immobilizes and protects a body part.

DIF: Cognitive Level: Knowledge REF: Text reference: p. 268

OBJ: Explain nursing measures for complications from traction.

TOP: Splints KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

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