A plan of care formulated by an operating room (OR) nurse includes four nursing diagnoses. Which diagnoses will the nurse include that is directly related to safety?
A) Deficient knowledge regarding drug therapy
B) Disturbed sensory perception (kinesthetic, tactile) related to anesthesia
C) Risk for impaired skin integrity related to immobility
D) Risk for injury related to central nervous system (CNS) depressive effects of drugs
D
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The nursing diagnosis, which directly relates to safety, is high risk for injury. The other three options are only indirectly related to safety. While in the OR, the patient under general anesthetic is unable to express safety concerns and must rely completely on the surgeon and OR staff for protection.
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