When the head injured patient is thrashing around in bed, the nurse's best intervention for preventing injury is to:
A) Restrain the patient.
B) Administer a narcotic analgesic.
C) Arrange for friends and family members to sit with the patient.
D) Pad the side rails.
Ans: D
Feedback: To protect the patient from self-injury, the nurse uses padded side rails. The nurse should avoid restraints because straining against them can increase ICP or cause other injury. Narcotics used to control restless patients should be avoided because these medications can depress respiration, constrict the pupils, and alter the patient's responsiveness. Visitors should be limited if the patient is agitated.
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