A nurse is providing care for a confused client who repeatedly attempts to dislodge their peripheral intravenous (IV) catheter. Which of the following actions should the nurse implement first as a less restrictive alternative to physical restraints?
- Cover the IV insertion site and tubing with a stockinette dressing to keep it out of the client's line of sight.Answer
- BPlace padded mitts on the client's hands to prevent them from successfully grasping the IV tubing.
- CContact the primary healthcare provider to request a prescription for a sedative medication to calm the client.
- DAssign an unlicensed assistive personnel (UAP) to assess the client's behavior and orientation every hour.
Answer
Cover the IV insertion site and tubing with a stockinette dressing to keep it out of the client's line of sight.
Concealing medical lines with a stockinette, long sleeves, or a light bandage removes the visual stimulus that often prompts confused clients to pull at their devices. This is a highly effective, non-restrictive, and safe first-line intervention that preserves the client's freedom of movement without the use of physical restraints.
Step-by-Step Solution
Key Concept
Less Restrictive Alternatives to Restraints