Following an intentional medication overdose, a client is transferred from the emergency department to the inpatient behavioral health facility. The primary healthcare provider prescribes continuous one-to-one suicide precautions. Which interventions should the practical nurse (PN) incorporate into the client's care? (Select all that apply.)
- Inventory the client's personal belongings and confiscate items such as belts, shoelaces, and glass objects.Answer
- Maintain an arm's-length distance and uninterrupted visual contact with the client, including during toileting and showering.Answer
- CAsk the client directly why they decided to take the medication overdose.
- Serve meals using exclusively paper or plastic service items and verify that all utensils are returned when removing the tray.Answer
- EReassure the client by stating that they are in a safe environment and their feelings of despair will eventually pass.
- FProvide a degree of privacy by remaining just outside the slightly ajar bathroom door while the client uses the facilities.
Answer
The appropriate interventions for a client on continuous one-to-one suicide precautions include inventorying belongings to remove hazards, maintaining uninterrupted visual contact (even during hygiene), and ensuring meal trays have safe utensils that are counted upon return.
For a client on strict one-to-one suicide precautions, the highest priority is maintaining a safe environment and preventing self-harm. This requires continuous, uninterrupted visual observation at all times (including during hygiene), removing any potentially hazardous personal belongings, and strictly controlling and counting safe meal utensils.
Step-by-Step Solution
Key Concept
Suicide Precautions and Environmental Safety