Difficulty: Medium
Average Score: 72%
Simulated
A nurse is caring for a client who is aggressive toward other clients and has been placed in wrist restraints. After obtaining a prescription for restraints from the provider, which of the following actions should the nurse take?
Correct answer
C
Rationale
The correct answer is C. Conduct a debriefing regarding the client with the unit staff. After placing a client in restraints, it is essential to conduct a debriefing with the unit staff to discuss the client's behavior, the reasons for using restraints, and any alternative strategies that could be implemented to prevent future aggressive behavior. This debriefing helps ensure a holistic approach to the client's care and promotes a collaborative effort among the healthcare team to address the client's needs effectively.
Option A is incorrect because documenting the client's behavior once every hour is important but does not address the need for debriefing and collaboration with the unit staff. Option B is incorrect as restraining a client until the prescription expires without reassessment is not best practice and may compromise the client's well-being. Option D is incorrect as requesting an evaluation within 12 hours of restraint application is important but does not replace the need for debriefing and collaboration with the unit staff.
Option A is incorrect because documenting the client's behavior once every hour is important but does not address the need for debriefing and collaboration with the unit staff. Option B is incorrect as restraining a client until the prescription expires without reassessment is not best practice and may compromise the client's well-being. Option D is incorrect as requesting an evaluation within 12 hours of restraint application is important but does not replace the need for debriefing and collaboration with the unit staff.