The nurse educator is planning various seminars for the staff nurses regarding care of the patient in physical restraints. Which essential nursing interventions will the educator include in the staff seminar? Select all that apply
1. Turn patient every 4 hours.
2. Toilet the patient as needed.
3. Assign one-to-one observation.
4. Assess skin integrity every hour.
5. Assess circulation, sensation, and movement every 6 hours.
Answer: 2, 3, 4
Explanation: Appropriate nursing interventions for the patient in physical restraints include toileting the patient as needed, assigning a one-to-one observation, and assessing the patient's skin integrity every hour. The nurse should turn the patient and assess circulation, sensation, and movement every 2 hours, not every 4 or 6 hours.
You might also like to view...
A conflict arises in a critical care unit when team members differ on how aggressively they want to treat a patient diagnosed with HIV. The team should see input from
A) hospital administrators. B) the hospital ethics committee. C) a Catholic priest. D) a Protestant lay leader.
A patient is admitted to the critical care unit with acute respiratory failure. Upon auscultation, the health care provider hears creaking, leathery, coarse breath sounds in the lower anterolateral chest area during inspiration and expiration
The nurse suspects that the patient has a(n) a. emphysema. c. pulmonary fibrosis. b. atelectasis. d. pleural friction rub.
You observe that the right side of a patient's mouth droops and the affected side of her face appears flaccid. Which condition is most likely the cause of these findings?
a. depression c. dementia b. Bell's palsy d. hypothyroidism
Both aspirin and ibuprofen products inhibit which process in the body?
1. Histamine production 2. Platelet production 3. Cytokine IL-1 synthesis 4. Cyclooxygenase (COX) synthesis