A practical nurse (PN) is orienting a newly admitted client who has severe bilateral vision loss and diabetic peripheral neuropathy to a private room. Which of the following interventions should the PN implement to promote an accident and injury-free environment? Select all that apply.
- Describe the physical layout of the room and ensure the call bell is placed directly in the client's hand.Answer
- Keep the pathway between the client's bed and the restroom completely free of medical equipment and personal items.Answer
- Verify that the client's bed is in the lowest possible position and that the wheels are locked.Answer
- DSecure the client with a vest restraint while they are in bed to prevent them from attempting to ambulate unassisted.
- EConfirm the client's identity by checking the room and bed assignment board before administering scheduled medications.
- FAttribute any sudden onset of confusion during the shift to expected age-related changes without further assessment.
Answer
The correct interventions include describing the room layout and keeping the call bell in the client's hand, maintaining a clear pathway to the restroom, and ensuring the bed is in the lowest locked position.
Clients with visual and peripheral sensory deficits are at an exceptionally high risk for falls and environmental injuries. Describing the room layout and placing the call bell within the client's grasp empowers them to request help safely. Keeping pathways entirely clear of obstacles eliminates tripping hazards for a client who cannot see them or feel them adequately. Maintaining the bed in the lowest locked position minimizes the distance to the floor in the event of an unassisted transfer, reducing the severity of potential fall injuries.
Step-by-Step Solution
Key Concept
Environmental hazard mitigation and safe practice protocols for clients with sensory deficits.
Estimated Time:1m 30s