A nurse is assisting with the care of an adolescent client who is in skeletal traction for the treatment of a fractured femur. Which of the following actions should the nurse take?

Choice A rationale:
Gently lift the traction weights off the floor when repositioning the client. Rationale: This choice is not recommended in the care of a client in skeletal traction. Traction weights should never be lifted off the floor as they provide the necessary counter traction to align and immobilize the fractured bone. Lifting the weights could disrupt the traction and jeopardize the healing process.
Choice B rationale:
Reduce intake of foods containing fiber while nonambulatory. Rationale: While constipation can be a concern for clients in skeletal traction due to decreased mobility, reducing fiber intake is not the appropriate intervention. Adequate fiber intake is important to promote regular bowel movements and prevent constipation. Hydration and mobility exercises are more suitable approaches to manage constipation.
Choice C rationale:
Perform passive range-of-motion exercises to the affected extremity every 2 hours. Rationale: Passive range-of-motion exercises are important to maintain joint mobility and prevent muscle atrophy in a nonambulatory client. However, performing these exercises every 2 hours might be excessive and could cause unnecessary discomfort for the client. Range-of-motion exercises are usually done every 4 to 8 hours to strike a balance between maintaining joint health and providing rest.
Choice D rationale:
Apply protective padding to the end of the pin sites. Rationale: This is the correct choice. Applying protective padding to the end of the pin sites is crucial to prevent pressure ulcers and infection. The pin sites are potential entry points for bacteria, and protecting them helps reduce the risk of infection. Padding also prevents pressure on the skin and underlying tissues, reducing the potential for pressure injuries.

The correct answer is choice D, wooden building blocks.

Choice A rationale:

Colored paper and safety scissors are not appropriate for an 18-month-old child due to safety concerns. At this age, children are still developing fine motor skills and coordination, and the use of scissors, even safety ones, poses a risk of injury.

Choice B rationale:

Stringing beads is not suitable for an 18-month-old child as it requires more advanced fine motor skills and could pose a choking hazard. Children at this age are still prone to exploring objects by putting them in their mouths.

Choice C rationale:

Alphabet flash cards are not the best choice for an 18-month-old child with pneumonia. While flash cards can be educational, they are more suited for older children who are beginning to learn letters and words. At 18 months, play should focus on sensory and motor skill development rather than academic learning.

Choice D rationale:

Wooden building blocks are the most appropriate choice for an 18-month-old child. They encourage play that is developmentally supportive, promoting fine motor skills and creativity. Blocks can be easily handled by small hands, and there is no risk of injury or choking. Additionally, building and knocking down block towers can provide a sense of accomplishment and enjoyment for the child.