A nurse is reinforcing teaching with a client on measures to promote their sleep. Which of the following instructions should the nurse include in the teaching?

A. "You will receive moderate sedation prior to the procedure.": Moderate sedation is not typically required for a thoracentesis. Instead, local anesthesia is used at the puncture site to minimize discomfort. The client remains awake, able to follow instructions, and does not require the same level of monitoring associated with moderate sedation.

B. "You will need to lie on your affected side for 30 minutes following the procedure.": After a thoracentesis, clients are usually positioned on the unaffected side to allow the lung on the affected side to re-expand and to minimize the risk of complications such as pneumothorax. Lying on the affected side could worsen the client's condition post-procedure.

C. "You will not be able to eat or drink four hours prior to the procedure.": Thoracentesis is not a gastrointestinal or airway procedure that necessitates fasting beforehand. Clients are typically allowed to eat and drink normally unless another procedure requiring fasting is planned, as the risk of aspiration is minimal with thoracentesis.

D. "You will be placed leaning over a bedside table during the procedure.": Clients undergoing thoracentesis are positioned sitting upright, leaning slightly forward over a bedside table with pillows for support. This position helps spread the ribs apart and provides the best access to the pleural space while minimizing the risk of lung injury.

A. Apply restraints according to the facility's standing order: Restraints should never be applied based on a standing order. Each use of restraints requires a specific, immediate provider order following a thorough assessment of the situation.

B. Obtain a PRN prescription for restraints from the provider: PRN (as-needed) orders for restraints are not appropriate. Restraints must be ordered specifically when the need arises, after evaluating less restrictive measures.

C. Stand in front of the client to block them from others in the room: Standing directly in front of a combative client can escalate the situation and put the nurse at risk of injury. Maintaining a safe distance and using de-escalation techniques are safer strategies.

D. Ensure there are enough staff members available for assistance: Ensuring sufficient staff presence is critical when a client becomes combative. It helps ensure the safety of the client, other clients, and staff members, and allows for a coordinated response if physical intervention becomes necessary.