A nurse working on an orthopedic unit is caring for four clients. Which of the following clients should the nurse identify as being at greatest risk for skin breakdown?

The correct answer is B. The older adult with a hip fracture in Buck's traction is at the greatest risk for skin breakdown. Buck's traction exerts continuous pressure on the skin, increasing the risk of pressure ulcers. The other clients are not at as high risk. A young adult in skeletal balanced suspension traction has even distribution of weight, reducing pressure points (A). An adolescent in a halo brace has limited mobility but the pressure is not continuous like in traction (C). A middle adult with a fractured radius in an arm cast has localized pressure, which is less likely to cause breakdown compared to continuous pressure of traction (D).