A nurse is collecting data from a client who is taking propranolol. The nurse should monitor the client for which of the following adverse effects?

A. Document in the client's medical record every 15 min: Frequent documentation is required to monitor the client’s safety, physical and psychological status, and ongoing need for restraints. This includes checking circulation, skin integrity, respiratory status, and mental condition. Documentation every 15 minutes ensures compliance with regulatory standards and provides a detailed record of care while the client is restrained.

B. Offer toileting to the client every 4 hr: Clients in restraints should be offered toileting, hydration, and nutrition more frequently than every 4 hours, generally every 1–2 hours, to prevent complications such as skin breakdown, urinary retention, or dehydration. Waiting 4 hours is unsafe and does not meet standard restraint care guidelines.

C. Remove the restraint when the client falls asleep: Restraints should not be removed solely based on sleep. Continuous monitoring is essential, and restraints are only removed or adjusted based on the client’s behavior, safety status, and provider orders. Sleep does not automatically indicate that the client is safe to be unrestrained.

D. Request that the provider write an as-needed prescription for restraints: Restraints cannot be prescribed on an as-needed basis. They must be ordered with specific parameters including type, duration, and reason for use. Using restraints without a proper order or relying on as-needed instructions is outside legal and professional practice standards.

A. Basketball: Basketball is a high-impact, contact sport that involves frequent running, jumping, and potential collisions with other players. Children with hemophilia are at increased risk for joint and soft tissue bleeding from trauma, so participation in basketball is not recommended.

B. Gymnastics: Gymnastics involves tumbling, jumping, and apparatus use, which can lead to falls and injuries. These activities carry a high risk of trauma-induced bleeding for children with hemophilia, making it an unsafe choice.

C. Swimming: Swimming is a low-impact sport that promotes cardiovascular fitness, muscle strength, and joint mobility without significant risk of trauma. Water-based activities are safe for children with hemophilia, providing exercise benefits while minimizing bleeding risk.

D. Golf: Golf is a non-contact, low-impact sport that allows children to participate safely without high risk of injury. It promotes coordination, concentration, and mild physical activity without placing stress on joints or increasing the likelihood of bleeding.

E. Soccer: Soccer is a contact sport with frequent running, collisions, and potential falls, increasing the risk of bleeding in joints and muscles. For children with hemophilia, soccer is generally considered unsafe due to the high potential for injury.