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Difficulty: HardErgonomics and Safe Use of Equipment

A practical nurse (PN) is caring for a client with a high body mass index (BMI) who is hospitalized for severe pneumonia. During the night shift, the client becomes acutely disoriented, combative, and slides dangerously close to the foot of the bed, which severely compromises their respiratory expansion. The PN must move the client back up in bed. Which approach represents the safest application of ergonomic principles and equipment management?

  1. Recruit at least one additional healthcare worker, adjust the bed height to the waist level of the shortest team member, and utilize a friction-reducing slide device to move the client on a coordinated count.Answer
  2. B
    Immediately secure the client's upper extremities with soft restraints to halt the resistance, then firmly grasp the underlying bed linen to physically drag the client upward.
  3. C
    Comply with a verbal order to administer a rapid intravenous (IV) bolus sedative to chemically calm the client before attempting a single-person manual lift.
  4. D
    Attribute the sudden agitation to an expected age-related cognitive decline, leave the client at the foot of the bed to prevent further conflict, and monitor oxygenation.

Answer

Recruit at least one additional healthcare worker, adjust the bed height to the waist level of the shortest team member, and utilize a friction-reducing slide device to move the client on a coordinated count.
The safest approach prioritizes both client stability and nurse ergonomics. By recruiting help, using a friction-reducing device, and setting the bed to the shortest worker's waist level, the nurses minimize musculoskeletal strain and prevent skin shear on the client.

Step-by-Step Solution

1
Assess the client's size, combativeness, and the immediate risk to their respiratory status.
The nurse identifies the need for a multi-person lift using assistive equipment due to the client's BMI and agitation.
Safe patient handling algorithms dictate that bariatric or combative clients cannot be manually lifted by a single person.
2
Gather appropriate personnel and a friction-reducing slide device.
The necessary resources are assembled to perform the task safely.
Friction-reducing devices lower the physical exertion required by staff and protect the client's skin integrity from shear forces.
3
Adjust the bed height to the waist level of the shortest caregiver.
The environment is ergonomically optimized for the team.
Adjusting to the shortest worker prevents them from having to reach upward and overextend, while taller workers can widen their stance to accommodate the height safely.

Key Concept

Safe Patient Handling and Ergonomics
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Topics

Ergonomics and Safe Use of Equipment

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