A nurse is caring for a client who has atopic dermatitis and a prescription for triamcinolone ointment. The nurse should assess the client to monitor for which of the following adverse effects?

Rationale:
A. Verify the alarm settings on the ventilator: Ensuring alarms are properly set is a routine safety check but does not directly address the client's agitation or risk of self-extubation. It is important but not the priority action in this scenario.

B. Turn on the television: Providing distraction may help reduce mild anxiety but is insufficient for managing significant agitation in a mechanically ventilated client who may become dangerous to themselves if they pull out the endotracheal tube.

C. Obtain a prescription for a vest restraint: Physical restraints should be a last resort after attempting less restrictive methods. Using restraints without addressing the underlying cause of agitation (e.g., discomfort, anxiety, pain) can increase distress and injury risk.

D. Administer a sedative medication: Sedation is appropriate for a mechanically ventilated client who is agitated and at risk for self-extubation. Sedatives help ensure patient comfort, reduce anxiety, and promote ventilator synchrony while protecting the airway.

Rationale:

A. Instruct the client to lift no more than 6.8 kg (15 lb) when at home: While it is important to avoid heavy lifting after a lumbar laminectomy, specific weight limits should be prescribed by the provider or physical therapist. Also, this instruction is more appropriate for discharge teaching, not immediate postoperative care.

B. Turn the client by log rolling with a turning sheet: Log rolling maintains spinal alignment and minimizes twisting of the spine, which is critical after spinal surgery. It prevents stress on the operative site and reduces the risk of complications such as spinal cord or nerve injury.

C. Inform the client to shower on the second postoperative day: Showering is usually permitted after surgical wounds have started to seal, but the exact timing depends on the surgeon's orders and the condition of the incision. Automatic showering on day two may not be safe for all clients.

D. Remove sterile adhesive strips before discharge: Sterile adhesive strips (such as Steri-Strips) are typically left in place until they fall off naturally or are removed by a healthcare provider at a follow-up visit. Removing them prematurely can increase infection risk or disrupt healing.