A nurse is assisting in caring for a client who is in Buck's traction. Which of the following actions should the nurse take?

Buck’s traction is a type of skin traction used to immobilize and align fractures of the lower extremity, commonly the hip or femur. It relies on a constant pulling force to maintain proper bone alignment and reduce muscle spasms. Proper application and maintenance are essential to ensure therapeutic effectiveness and prevent complications such as neurovascular compromise or skin injury. Nursing care focuses on maintaining traction alignment, monitoring circulation, and ensuring safety of the system. Rationale: A. Ensuring the weights are hanging freely is essential because traction depends on continuous, uninterrupted pulling force. If weights rest on the floor or bed, the traction force is disrupted, which can lead to loss of alignment and ineffective treatment. Free-hanging weights maintain consistent tension on the affected limb for proper bone stabilization. B. Maintaining elevation of the head of the bed is not a priority specific to Buck’s traction. Slight elevation may be used for comfort or respiratory support, but it does not directly impact the effectiveness of traction. The key priority is maintaining proper alignment and ensuring the weights remain unobstructed. C. Checking the client’s skin twice daily for breakdown is important but not the most immediate priority in traction management. Skin integrity should be assessed regularly, especially under straps and bony prominences, but ensuring correct traction setup takes precedence to maintain therapeutic effectiveness. D. Monitoring capillary refill once per day is insufficient because neurovascular checks in traction clients should be performed more frequently. Capillary refill, along with pulse, color, temperature, and sensation, should be assessed at least every few hours to detect early signs of impaired circulation or compartment syndrome.