A 5-year-old boy was diagnosed with Duchenne muscular dystrophy less than 18 months ago.

The client presents with fatigue, and muscular weakness and is having difficulty running, and often falls majority of his attempts.

Which of the following would the nurse expect to be elevated in Duchenne muscular dystrophy?

Elevated levels of MSAFP may indicate that the baby is at risk of a neural tube defect, like spina bifida.
However, further testing is required to confirm the results and determine the cause of the elevated levels.

Choice A is incorrect because low levels of MSAFP may indicate a risk for Down syndrome, not elevated levels.
Choice B is incorrect because while elevated levels of MSAFP may indicate a risk for neural tube defects, further testing is required to confirm this.
Choice D is incorrect because while repeating the test may be necessary, further testing beyond just repeating the MSAFP screening may also be required.

Choice A reason:
Placing traction weights so they touch the head of the bed disrupts the effectiveness of the traction system. Skeletal traction relies on a continuous pulling force to maintain proper alignment of the fractured femur. If the weights are resting on any surface, the force is interrupted, which can lead to complications such as malunion or delayed healing. The weights must hang freely at all times to ensure therapeutic benefit.

Choice B reason:
Isometric exercises are beneficial for maintaining muscle tone and promoting circulation during immobilization. However, while this is a supportive intervention, it is not the most critical or immediate nursing action in the context of skeletal traction. Encouraging exercises every 8 hours is appropriate, but it does not directly address the most urgent or discomfort-related aspect of care.

Choice C reason:
Pin care is a routine but potentially painful procedure associated with skeletal traction. Administering pain medication beforehand is a priority nursing action because it ensures client comfort, reduces anxiety, and promotes cooperation during the procedure. This intervention reflects both compassionate care and adherence to best practices in pain management and infection prevention.

Choice D reason:
Repositioning a client in skeletal traction must be done with extreme caution to avoid disrupting the traction setup. Assisting the client to shift position every 4 hours may inadvertently alter the alignment or tension of the traction apparatus. While pressure injury prevention is important, repositioning must be coordinated carefully and is not the most appropriate standalone action in this context.