The nurse determines that an older adult who has chronic bronchitis is at high risk for falls, but he repeatedly tries to ambulate without assistance. Which alternative measure to restraints is contraindicated for this older adult?
a. Inform the staff about his risk for falls.
b. Place a concave mattress on the bed.
c. Provide frequent walks in the hallway.
d. Help him learn to use an assistive device.
B
A concave mattress is a restraint alternative, but it is contraindicated for this patient who has chronic bronchitis because lowering the relative position of his torso in relationship to the head and lower extremities places extra pressure on the diaphragm and restricts chest expansion, which makes the work of breathing significantly more difficult for him and is contraindicated because chronic bronchitis is an obstructive breathing disorder. Communicating the risk for falls is a suitable alternative measure to restraints for him; it employs multiple people to observe, manage, and lower his fall risk. Providing frequent walks can be an effective restraint alternative for this older adult if he is restless or bored. Finally, the nurse can help him learn how to use an assistive device to help avoid the use of restraints.
You might also like to view...
The nurse must irrigate the colostomy of a patient who is unable to move independently. How should the nurse position the patient for this procedure?
1) Semi-Fowler's position 2) Left side–lying position 3) Supine with the head of the bed lowered flat 4) Supine with the head of bed raised to 30 degrees
The current emphasis on eliminating racially based health disparities is based on which of the following ethical principles?
a. Double effect b. Fidelity c. Justice d. Veracity
Today's nurse functions in a number of roles. The activities of a nurse include preparing a document based on the client's responses, preparing plans with input from other healthcare staff members, recording medication and treatments, and verbalizing
events with other healthcare team members. In this case, which role is the nurse performing? A) Care provider B) Advocate C) Communicator D) Teacher
A mother rescues two of her four children from a house fire. In an emergency department, she cries, "I should have gone back in to get them. I should have died, not them." Which of the following responses by the nurse is an example of reflection?
A. "The smoke was too thick. You couldn't have gone back in." B. "You're feeling guilty because you weren't able to save your children." C. "Focus on the fact that you could have lost all four of your children." D. "It's best if you try not to think about what happened. Try to move on."