A nurse in an acute facility is assisting with the development of an in-service about reducing environmental stressors to improve client’s sleep. Which of the following instructions should the nurse include?

Turn on overhead lights briefly when checking IV line

Open curtains between clients semiprivate rooms

Conduct change-of-shift report near the clients’ rooms.

Wear shoes with rubber soles

Answer and Explanation

The Correct Answer is D

A) "Turn on overhead lights briefly when checking IV line.": Turning on overhead lights can disrupt the client’s sleep, especially if done during the night. Light exposure can interfere with the body’s natural circadian rhythm, making it harder for the client to fall asleep and stay asleep. A more appropriate action would be to use a dim light or portable light to minimize disturbance.

B) "Open curtains between clients’ semiprivate rooms.": Opening the curtains between semiprivate rooms could increase noise and visual distractions, which may disturb the client's sleep. Keeping the environment as calm and private as possible is essential to reduce stress and promote restful sleep. Curtains should ideally remain closed to promote privacy and minimize distractions.

C) "Conduct change-of-shift report near the clients’ rooms.": Conducting report near the client's rooms can create unnecessary noise and disturb the client’s sleep. The change-of-shift report should ideally take place in a designated area, away from patient rooms, to reduce noise and disturbances in the environment.

D) "Wear shoes with rubber soles.": Wearing shoes with rubber soles reduces noise when walking, which is particularly important in an acute care setting where patients need rest. Quiet movement helps to maintain a peaceful environment, reducing the environmental stressors that can impact sleep quality for clients.

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Correct Answer is A

Explanation

A) You can splint the incision with a pillow when changing position: Splinting the incision with a pillow is an excellent nonpharmacological method to manage pain during position changes after a cesarean section. The pillow helps provide support to the incision site, reduces strain on the abdominal muscles, and minimizes discomfort when the client moves. This is a safe and effective intervention to help with pain management.

B) You should change position as little as possible: While minimizing movement might seem like a way to prevent pain, it can lead to complications like muscle stiffness, poor circulation, and respiratory issues. It’s important for clients to change positions to promote comfort, circulation, and lung expansion, but they should do so with support to manage pain effectively.

C) You should use patterned paced breathing when changing positions: Patterned paced breathing is a helpful relaxation technique that can be used in various situations, including labor and delivery. However, it is not the most appropriate response in this context, as the client’s pain is more related to physical discomfort from the incision, and physical support (like splinting the incision) would be more effective in managing this type of pain.

D) You can apply counterpressure to your back with each position change: While counterpressure can be beneficial for back pain during labor, it is not the most relevant technique for managing pain after a cesarean section, where the pain is related to the abdominal incision site. Splinting the incision provides more targeted support for post-cesarean discomfort.

A. Administer aspirin for pain. B. Initiate bed rest. C. Massage the affected extremity every 4 hr. D. Apply an ice pack to the affected extremity for 20 min every 2 hr.

Correct Answer is D

Explanation

A) Administer aspirin for pain: Aspirin is an anticoagulant and should be avoided in clients receiving other anticoagulant therapy, especially in the context of deep vein thrombosis (DVT). Using aspirin could increase the risk of bleeding and complications. Therefore, it is not appropriate for pain management in this situation.

B) Initiate bed rest: While rest may be indicated for comfort and to reduce the risk of further clot formation, complete bed rest is generally not recommended in the management of DVT unless specifically directed by the healthcare provider. Early ambulation and the use of compression devices or stockings are typically encouraged to promote circulation and reduce the risk of complications, such as pulmonary embolism.

C) Massage the affected extremity every 4 hr: Massaging the affected extremity is contraindicated in a client with DVT, as it can dislodge the clot and increase the risk of a pulmonary embolism or other complications. It is important to avoid any direct manipulation of the affected limb to prevent causing harm.

D) Apply an ice pack to the affected extremity for 20 min every 2 hr: Applying an ice pack is
an appropriate intervention for reducing swelling and providing comfort in the case of a DVT. The cold therapy helps to constrict blood vessels, reduce inflammation, and relieve pain. This intervention should be done carefully to avoid skin damage, and the nurse should monitor the skin for signs of injury.

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A nurse in an acute facility is assisting with the development of an in-service about reducing environmental stressors to improve client’s sleep. Which of the following instructions should the nurse include?

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Explanation

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