A client in skeletal traction develops increased pain. What should the nurse first assess?

When a client in skeletal traction develops increased pain, the first assessment should focus on circulation compromise. This is crucial because skeletal traction involves the application of a pulling force to align and stabilize fractured bones, which can sometimes lead to complications such as neurovascular compromise. Increased pain may indicate that circulation to the affected limb is being impaired, which can result from swelling, excessive traction force, or positioning that constricts blood flow.

Assessing for circulation involves checking the pulse, capillary refill, temperature of the skin, and sensation in the distal extremities. Prompt recognition of any signs of compromised circulation is essential, as this can lead to serious complications if not addressed quickly.

Other assessments, such as checking the pin site for infection or changes, are also important but are secondary in urgency to ensuring that blood flow and nerve function are maintained. Evaluating range of motion exercises is not relevant in the context of increased pain, as the priority is to identify and address any immediate threats to circulation. Therefore, focusing on circulation assessment first allows the nurse to intervene appropriately and prevent further complications.