An 11-month-old hospitalized boy is restrained because he is receiving intravenous (IV) fluids. His grandmother has come to stay with him for the afternoon and asks the nurse if the restraints can be removed. What nurse's response is best?
a. "Restraints need to be kept on all the time."
b. "That is fine as long as you are with him."
c. "That is fine if we have his parents' consent."
d. "The restraints can be off only when the nursing staff is present."
ANS: B
The restraints are necessary to protect the IV site. If the child has appropriate supervision, restraints are not necessary. The nurse should remove the restraints whenever possible. When parents or staff members are present, the restraints can be removed and the IV site protected
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