A nurse is caring for a client who is at risk for respiratory alkalosis. Which of the following alterations should the nurse identify as an increased risk for this condition?

A. Apply mitten restraints to prevent the client from disconnecting their tube feeding: Mitten restraints are often used to prevent clients from pulling out tubes or disrupting medical devices. The nurse can apply these restraints as long as they follow the prescribed protocol.

B. Apply soft heel protectors bilaterally while client is in bed: Soft heel protectors are commonly used to prevent pressure ulcers or skin breakdown in immobile clients. This is a standard, non-controversial intervention and does not require verification.

C. Applying a vest restraint daily at bedtime to prevent nighttime wandering is considered a physical restraint used for convenience or punishment, which is a violation of client rights and safety. Restraints should only be used as a last resort when all less restrictive alternatives have failed and for the shortest duration possible.

D. Apply an abduction pillow between the client's knees while they are in bed to prevent hip dislocation: The use of an abduction pillow is common after hip replacement surgery or for patients at risk of hip dislocation. This is an appropriate intervention.

A. "The lockout interval prevents me from receiving too much medication.": The lockout interval on a PCA pump ensures that the client cannot administer more medication than is safe within a set period, preventing overdose or over-sedation.

B. "Each time I push the button, I receive the same amount as a morphine injection.": The PCA pump delivers a smaller, controlled dose of morphine each time the button is pressed, rather than the same dose as a traditional injection.

C. "My family can push the button for me on a regular basis.": The client should be the only one pressing the PCA button to prevent overdose and ensure safe administration. Family members should not push the button for the client.

D. "It will take about 30 minutes to feel relief after I push the button.": PCA delivers pain medication on demand, and the client may feel relief within a few minutes, not 30 minutes. Pain relief can be quicker depending on the medication’s action and how it’s delivered.