The nurse is caring for a client on a Rotokinetic bed after a spinal cord injury. Which is the best nursing intervention for client disorientation and uncooperativeness?

Question

1. Install a mirror for client viewing.
2. Administer short-acting sedatives.
3. Decrease rotation to 12 hours daily.
4. Collaborate with psychiatric service.

Answer 1

1
1. The best intervention for the client who is disoriented and uncooperative on a Ro-tokinetic bed is to install a mirror for client viewing so the client can watch the im-mediate environment. As part of the intervention, the nurse orients the client to the surroundings, the people, the time, and the place frequently until the client maintains orientation and becomes more cooperative. This is the best intervention because it avoids the sensory deprivation associated with sedation, decreases the need for a consultation and the potential for addition medication, and facilitates skin care by allowing the bed rotations to continue properly.
2. Sedation alters the client's senses potentially resulting in sensory deprivation, dis-tortion, misinterpretation, and additional complications. In addition, sedatives are likely to prolong client disorientation and create a risk for dependence on highly ad-dictive agents.
3. The client needs rotation for 20 out of 24 hours a day for effective therapy on a Rotokinetic bed because the prolonged periods of motion work to provide the benefit.
4. Collaborating for a psychiatric consultation is a poor intervention but is potentially a last resort for the client who fails to adjust to the Rotokinetic bed.