Difficulty: Medium
Average Score: 68%
Simulated
A nurse manager is updating protocols for the use of belt restraints. Which of the following guidelines should the nurse manager include?
Correct answer
D
Rationale
The correct answer is D, to document the client's condition after every 15 minutes. This guideline is crucial for monitoring the client's response to the restraint and ensuring their safety. Regular documentation helps detect any signs of distress, circulation issues, or skin breakdown promptly. Option A is incorrect as PRN restraint prescriptions are not recommended due to potential misuse. Option B is incorrect as restraints should be removed as soon as possible, not at a fixed interval. Option C is incorrect as restraints should be attached to the bed frame, not side rails.