A head nurse is concerned about the frequency of patient violence on her unit. Which of the following actions would be likely to reduce such incidents? Select all that apply
a. Encourage staff to have numerous, brief, nondirective interactions with all patients starting at admission.
b. Increase the percentage of males working on the unit so that the male presence will inhibit violent behavior.
c. Make sure a thorough assessment of risk for violence is completed on all patients at admission.
d. Train staff to implement seclusion and restraint promptly when a patient shows signs of escalating aggression.
e. In supervision, facilitate self-awareness regarding staff's feelings about violence and any possible nontherapeutic responses that might result from these feelings.
f. In cases where several or more patients on the unit are prone to violence, set stricter rules and limits on the unit to maintain a high degree of staff control.
A, C, E
Frequent neutral or positive interactions build trust in staff, which in turn increases staff effectiveness in de-escalation situations, reducing violence. Thorough risk assessments are essential to identifying and responding quickly and therapeutically to patients who are at high risk of violence. Staff self-awareness about their feelings and responses to aggression and violence is essential to assuring that nursing interventions will be prompt and therapeutic. An increased presence of male staff does not necessarily reduce patient violence; both male and female staff should be equally highly skilled in violence prevention and de-escalation. De-escalation techniques should be used before restrictive responses such as restraint or seclusion are considered; relying on restrictive responses can intensify rather than reduce patient violence. Research suggests that a reduced sense of control over one's circumstances can contribute to increased violence.
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The nurse working in a custodial care facility walks into a room to administer medication and finds the client having a sexually intimate encounter with another client. The nurse's best action at this time is to:
1. Make a noise to indicate that the nurse is in the room, and wait for the clients to regain composure. 2. Call Security to investigate the matter. 3. Quietly leave the room and knock on the door. 4. Notify the RN supervisor and physician.
Ergot derivatives are not generally used for inducing labor because they:
a. only stimulate uterine contractions during the second trimester. b. produce powerful uterine contractions. c. tend to increase breast engorgement. d. cause hypotension in many clients.
A patient is taking ginkgo biloba, a botanical supplement. She asks the nurse if it would be safe to take aspirin for her arthritis at the same time. The nurse's response is based on what knowledge?
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