What is critical information for the nurse to incorporate into her care when using restraints on a child?
a. Use the least restrictive type of restraint.
b. Tie knots securely so they cannot be untied easily.
c. Secure the ties to the mattress or side rails.
d. Remove restraints every 4 hours to assess skin.
ANS: A
When restraints are necessary, the nurse should institute the least restrictive type of restraint. Knots must be tied so that they can be easily undone for quick access to the child. The ties are never tied to the mattress or side rails. They should be secured to a stable device, such as the bed frame. Restraints are removed every 2 hours to allow for range of motion, position changes, and assessment of skin integrity.
You might also like to view...
What nursing diagnosis would a circulating nurse use on his or her intraoperative patients who receive general anesthesia? (Select all that apply.)
A) Disturbed sensory perception B) Risk for hypovolemia C) Risk for latex allergy response D) Disturbed body image E) Anxiety
The nurse is answering questions regarding fecal matter for a client who is scheduled for a colon resection. The client is asking questions regarding the composition of the fecal matter and when it becomes a formed mass
The nurse is most correct to state at which location? A) Ileum B) Cecum C) Sigmoid colon D) Duodenum
What should the leader remember in forming committees?
A) Committees work best when there is an adequate supply of workers, with 10 members being the minimum. B) Willingness to work hard is the most important criterion for appointment. C) Written agendas provide excessive structure and stifle committee creativity. D) There should be sufficient expertise among committee members to accomplish the assigned task.
All of the following activities are normally undertaken as part of doing an integrative review except:
A) Contacting principal investigators of key studies B) Selecting a sample C) Systematically recording data D) Evaluating the scientific merit of studies