A nurse is assisting with the care of a newborn.

For each potential nursing intervention, click to specify if the action appropriate, nonessential, or contraindicated for the newborn.

A. "I will sleep on a soft mattress.": A soft mattress does not provide adequate joint support and may allow excessive joint flexion, increasing stiffness and discomfort in osteoarthritis. Firm or supportive surfaces help maintain proper spinal alignment and reduce mechanical stress on weight-bearing joints.

B. "I will apply a heating pad to make my hands feel better.": Heat therapy promotes vasodilation, increases blood flow, and relaxes periarticular muscles, which can reduce stiffness and improve joint mobility in osteoarthritis. Application of warm compresses or heating pads is particularly beneficial before activity to decrease morning stiffness and enhance range of motion.

C. "I will take aspirin on an empty stomach.": Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can irritate the gastric mucosa by inhibiting prostaglandin synthesis, increasing the risk of gastritis and gastrointestinal bleeding. Taking these medications with food or milk reduces gastric irritation.

D. "I will exercise my joints as much as I can when they are inflamed.": During periods of acute inflammation, excessive joint use can worsen pain and tissue irritation. Low-impact, regular exercise is encouraged, but it should be balanced with rest during flare-ups to prevent additional joint stress and exacerbation of symptoms.

A. A client who is exhibiting flight of ideas: Flight of ideas indicates pressured, rapid speech and distractibility often seen in mania. While this requires monitoring and support, it does not pose an immediate risk of harm to the client or others.

B. A client who refuses to attend group therapy: Refusal to attend therapy reflects a non-urgent behavioral issue. The client’s autonomy should be respected, and interventions can be planned after more urgent concerns are addressed.

C. A client who is experiencing a moderate level of anxiety: Moderate anxiety may cause discomfort and decreased coping, but it does not typically create an immediate threat to safety. The nurse can intervene with calming techniques and support in a timely manner.

D. A client who is having command hallucinations: Command hallucinations can instruct the client to harm themselves or others, representing an immediate safety risk. The nurse should assess this client first to implement interventions that prevent potential harm and ensure safety on the unit.