A practical nurse (PN) receives a hand-off report for a client admitted with severe alcohol withdrawal. The off-going nurse states, "The client was shouting and pacing the room earlier, so the healthcare provider wrote a prescription for bilateral soft wrist restraints PRN (as needed) if the client becomes physically combative." Which action should the PN take?
- Withhold the implementation of the prescription and contact the healthcare provider.Cevap
- BApply the wrist restraints immediately to prevent the client from escalating to physical violence.
- CInstruct the assistive personnel (AP) to closely monitor the client and apply the restraints if combativeness occurs.
- DEnter the room to logically explain to the client why pacing is unsafe during the withdrawal process.
Cevap
The PN must withhold the implementation of the prescription and contact the healthcare provider because PRN (as needed) orders for restraints are legally prohibited.
Under strict federal guidelines and nursing standards of practice, physical or chemical restraints can never be prescribed on an 'as needed' (PRN) basis. A healthcare provider must evaluate the client in person and write a specific, time-limited prescription for restraints. Because the off-going nurse reported a PRN order, the receiving PN must recognize this as an invalid and illegal prescription, withhold its implementation, and contact the provider for a legally valid plan of care.
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Legal requirements and provider prescriptions for restraint application
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