The nurse is instructing unlicensed assistive personnel (UAP) on fall prevention for the clients. Which statement made by the UAP warrants further instruction?

1. "I will ensure that the call light is within reach of the client."
2. "I will make sure to have at least one side rail up at all times."
3. "I don't have to worry about the clients who are bedridden, as they are moved by the staff."
4. "I will make sure that the bed is in the lowest position prior to leaving the room."


3
Rationale 1: Ensuring that the call light is within reach of the client indicates appropriate understanding by the UAP on fall prevention strategies for the client.
Rationale 2: Leaving one side rail up at all times indicates an appropriate understanding by the UAP on fall prevention strategies for the client.
Rationale 3: The statement indicating not having to worry about clients who are bedridden because they are moved by staff is not correct as clients who are bedridden are more prone to falls due to the loss of independence.
Rationale 4: Ensuring that the bed is in the lowest position possible prior to leaving the room indicates an appropriate understanding by the UAP on fall prevention strategies for the client.
Global Rationale: The statement indicating not having to worry about clients who are bedridden because they are moved by staff is not correct as clients who are bedridden are more prone to falls due to the loss of independence. All the other statements indicate an appropriate understanding by the UAP on fall prevention strategies for the client.

Nursing

You might also like to view...

The spouse of a patient with Alzheimer's disease asks a nurse for more information about the rivastigmine [Exelon] transdermal patch that is being used. Which statement by the spouse indi-cates a need for further explanation?

a. "Doses are lower but more steady with the transdermal patch." b. "Reduced side effects occur with the transdermal patch." c. "We only need to change the patch every 2 weeks." d. "We should remove the old patch before applying the new one."

Nursing

A dosage of 0.5 g is ordered. Solution available is 500 mg/10 mL. Calculate the dosage volume

What will be an ideal response?

Nursing

Unlicensed assistive personnel are caring for a client's ears. What information should be reported to the nurse?

1. Excessive earwax 2. Loud talking 3. Presence of a hearing aid 4. Presence of any drainage

Nursing

When an older adult client receiving a blood transfusion presents with an elevated blood pressure, distended neck veins, and shortness of breath, the client is most likely experiencing:

A) allergic reaction. B) pulmonary embolism. C) fluid overload. D) anaphylaxis.

Nursing