A nurse is planning care for a client who has a newly placed percutaneous endoscopic gastrostomy (PEG) tube and is agitated and confused. The provider prescribes bilateral wrist restraints. Which of the following actions should the nurse plan to take?

Rationale

A. "I will sign my name now and leave a space for you to sign your name.": The nurse cannot pre-sign a prescription or leave a space for the provider, as this is legally and ethically inappropriate. All prescriptions must be verified and signed by the prescribing provider.

B. "Let me clarify that you want the medication given gid, correct?": The abbreviation "qid" (four times daily) is on The Joint Commission's (TJC) "Do Not Use" list due to its potential confusion with "qd" (daily) or "qod" (every other day). The nurse should instead ask the provider to clarify by stating the full term: "Do you mean four times a day?"

C. "Will you please spell the name of that medication for me?": Requesting the provider to spell the medication name ensures accuracy and prevents errors, particularly for medications with similar names or unfamiliar drugs. This is a critical safety step in telephone prescriptions.

D. "Let me provide you with the client's medical record number for identification.": Providing the client’s medical record number is important for identification but does not address the immediate need to verify the exact medication. Confirming the drug name takes priority in preventing medication errors.

Rationale:

A. Hypertrophic Scar: This image shows an abnormal, raised scar that is wider and more prominent than a normal healing scar, likely a hypertrophic scar which results from excessive collagen deposition during the healing process.

B. Dermatographia: This image displays urticarial (hive-like) lesions that appear as linear welts or swelling (wheals) on the skin of an arm. This is a common form of physical urticaria (hives). It is an exaggerated local skin response where light pressure, friction, or scratching results in localized vasodilation (redness) and edema (swelling/wheals) along the line of contact.

C. Psoriatic Plaque: This image displays a classic plaque-like lesion characteristic of Psoriasis. The characteristic features, a sharply demarcated, thickened (plaque), silvery-white scale covering a bright red, erythematous base. These plaques are often found symmetrically on the elbows, knees, scalp, and lower back.

D. Folliculitis: The lesions typically present as small, red bumps or pimples that may have a white or yellow center (a pustule) and usually center around a hair. The lesions in the image are discrete, erythematous (reddened), and scattered.