The nurse should perform which intervention when a client is restrained?
Answer(s): C
The minimum standard is to visually assess the restraint every 30 minutes. Documentation is typically performed per a checklist or flow sheet. The ends of the restraint are tied to a part of the bed that allows for position changes without unfastening them.
A client has been placed in isolation because he is diagnosed with a contagious illness. The nurse should be aware that ______________.
Answer(s): A
Linens should be double-bagged.Isolation refers to techniques used to prevent or to limit the spread of infection. Some form of isolation has been used for centuries, whether to protect a high-risk person from exposure to pathogens or to prevent the transmission of pathogens from an infected person to others.Special handling of articles and linen soiled by anybody fluid is indicated. These articles should be placed in impervious bags before they are removed from the client’s bedside.Bagging in watertight containers is indicated to prevent exposure of personnel and contamination of the environment.The outside of the bag should not be contaminated when placing articles inside it. Each hospital and community agency has procedures for labeling and decontaminating exposed articles.Items that are visibly soiled with body substances should be rinsed and placed in plastic bags or clearly marked containers, often labeled “Contaminated.” If the outside of the bag becomes contaminated, placing that bag in another bag (double-bagging) is required.
A patient placed under neutropenic precautions asks you how she can prevent infection. Which advice would be most appropriate?
An LPN is discussing medication safety with a toddler patient’s parent. Which statement made by the parent would be a cause for concern?
The LPN discovers an unconscious 8-year-old in the bathroom. She does a quick assessment and discovers he is not breathing and does not have a pulse. The LPN is alone and does not have quick access to a call button.What should she do first?
Answer(s): B
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