Final answer:
Appropriate nursing care for a patient with a C4 spinal cord injury in traction includes performing sterile pin care as ordered, not releasing the traction or loosening the pins without a physician's directive, and not elevating the head of the bed 90° unless prescribed.
Step-by-step explanation:
A client with a C4 spinal cord injury has been placed in traction with cervical tongs. Appropriate nursing care for such a patient includes performing sterile pin care as ordered. Sterile pin care is necessary to prevent infection at the pin sites. This involves cleaning around each pin with a sterile solution following aseptic techniques. It is important that traction is never released or interrupted unless specifically ordered by a physician, as this can be dangerous and lead to further spinal injury. Therefore, releasing the traction for five minutes each shift would not be appropriate.
Moreover, loosening the pins can be hazardous and should not be performed by nurses if the client complains of headaches; in such cases, the appropriate response is to report the symptom to a physician for evaluation. Finally, elevating the head of the bed 90° could potentially be harmful by increasing spinal cord pressure or interfering with the traction, and thus must be avoided unless specifically directed by the healthcare provider. Instead, care should involve ensuring that the head of the bed is kept at the angle prescribed by the healthcare provider, which is often a slight elevation to help maintain proper alignment and reduce the risk of complications.