A nurse manager is leading a discussion on legal guidelines for the use of restraints. Which of the following information should the nurse include?

"You can place a client in a chair with a table or tray blocking them as an alternative to restraints."

"Monitoring the client less often than required can be considered negligence."

"Family members cannot file a lawsuit when restraints are used for clients who have a mental illness."

"Chemical restraints are allowed when there is a high client-to-nurse ratio."

Answer and Explanation

The Correct Answer is B

A. "You can place a client in a chair with a table or tray blocking them as an alternative to restraints.": Using furniture to block a client can restrict their movement and may still be considered a form of restraint. Legal guidelines emphasize the importance of promoting client safety and dignity, so alternative measures should be explored that do not involve restricting movement.

B. "Monitoring the client less often than required can be considered negligence.": Monitoring a client in restraints less frequently than required breaches the duty of care and can lead to harm. Proper monitoring is crucial for the safety and well-being of clients, ensuring that their physical and psychological needs are adequately addressed while they are in restraints.

C. "Family members cannot file a lawsuit when restraints are used for clients who have a mental illness.": Family members retain the right to file lawsuits if they believe that the use of restraints was inappropriate or caused harm, regardless of the client's mental health status. Legal rights apply equally to all clients, including those with mental illness, ensuring accountability in the use of restraints.

D. "Chemical restraints are allowed when there is a high client-to-nurse ratio.": The use of chemical restraints is subject to strict regulations and cannot be justified based solely on staffing levels. These restraints should only be used when necessary for the client's safety and must align with established legal and ethical guidelines, ensuring that they are not used as a solution for managing staffing challenges.

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Correct Answer is A

Explanation

A. Hospital ethics committee: The nurse should consult the hospital ethics committee for guidance in resolving ethical conflicts related to client care. This committee is specifically designed to address ethical dilemmas and provide support for decision-making, ensuring that care aligns with ethical principles and the client's values.

B. Quality improvement committee: While the quality improvement committee focuses on enhancing care quality and patient safety, it is not primarily concerned with resolving ethical dilemmas. This committee may address systemic issues, but it does not specialize in ethical conflicts regarding individual client care.

C. Chaplain: While a chaplain can provide spiritual support and guidance, they may not be equipped to address the ethical aspects of the client's care. Consulting a chaplain could be helpful for emotional or spiritual concerns, but the ethics committee is more appropriate for resolving ethical dilemmas.

D. Director of nursing: The director of nursing may provide support and resources, but they may not have specialized training in ethics. Referring to the hospital ethics committee is more appropriate for addressing specific ethical conflicts in client care.

A. A client awaiting a screening colonoscopy later that day B. A client whose discharge was cancelled the prior day because they developed respiratory distress C. A client who is 6 hr postoperative following an open cholecystectomy D. A client who is prescribed gastric lavage treatments to treat acute aspirin toxicity

Correct Answer is A

Explanation

A. A client awaiting a screening colonoscopy later that day: This client is appropriate for early discharge. As the procedure is non-invasive and not urgent, the client can be discharged and return for the scheduled screening without compromising their health. This decision allows for the efficient use of hospital resources following a mass casualty event.

B. A client whose discharge was cancelled the prior day because they developed respiratory distress: Recommending discharge for this client is not advisable, as their recent respiratory distress indicates ongoing health issues that require monitoring and care. Early discharge could jeopardize their safety and recovery.

C. A client who is 6 hr postoperative following an open cholecystectomy: This client is not a suitable candidate for early discharge. Postoperative patients typically require observation and care to monitor for complications, such as infection or bleeding, in the hours following surgery. Early discharge could put this client's recovery at risk.

D. A client who is prescribed gastric lavage treatments to treat acute aspirin toxicity: This client should not be recommended for early discharge, as they require ongoing treatment and monitoring for aspirin toxicity. Discharging this client prematurely could lead to serious health complications and does not ensure their safety and well-being.

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A nurse manager is leading a discussion on legal guidelines for the use of restraints. Which of the following information should the nurse include?

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