The nurse is providing care to a patient receiving a neuromuscular blocking agent. Which of the following should be included in this patient's plan of care?
1. eye care
2. mouth care
3. monitor urine output
4. minimal movement
1
Rationale: Nursing care of a patient receiving a neuromuscular blocking agent should receive prophylactic eye care by keeping the eyes closed and covered with a soft eye pad and using eye lubricants or artificial tears. Mouth care should be provided to all patients in the intensive care unit, regardless of receiving a neuromuscular blocking agent. Urine output should also be monitored for all patients in the intensive care unit. Because the skin could breakdown, the patient should have frequent repositioning. Minimal movement will not prevent skin breakdown but increase the risk for development.
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