A nurse is caring for a pediatric patient in skeletal traction for a femur fracture. Which nursing action is the highest priority to prevent complications associated with skeletal traction?

A. Ensure the weights hang freely and do not touch the floor to maintain proper traction force is correct. Proper skeletal traction depends on continuous, consistent force applied through the weights. If the weights touch the floor or are obstructed, the traction is disrupted, which can result in malalignment, delayed healing, increased pain, or neurovascular compromise. Maintaining correct traction mechanics is the highest priority to prevent serious complications. B. Remove the traction weights every 6 hours is incorrect because weights should never be removed unless prescribed. Interrupting traction can cause muscle spasm, malalignment, or delayed fracture healing. Skin breakdown is addressed through regular skin care and positioning, not by removing weights. C. Limit monitoring of pin sites to once every 24 hours is incorrect because pin sites require frequent assessment (at least every 4–8 hours) for signs of infection, inflammation, or loosening. Infrequent monitoring increases the risk of osteomyelitis or local infection. D. Place the rope knot in contact with the pulley is incorrect because this would interfere with the smooth functioning of the traction system. The rope must move freely through the pulley to maintain proper tension and alignment.