A nurse manager is teaching a group of employees about standards for Quality and Safety Education for Nurses (QSEN). Which of the following statements by an employee should the nurse manager identify as an example of the QSEN concept of quality improvement?

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.

A. "I have a severe allergy to amoxicillin." A severe allergy to amoxicillin suggests a potential cross-reactivity with ceftriaxone, as both belong to the beta-lactam antibiotic class. While cross-reactivity between penicillins and cephalosporins is lower with third-generation cephalosporins like ceftriaxone, a history of severe allergic reactions, such as anaphylaxis, warrants consultation with the provider before administration.

B. "I get sick when I take diuretics." Adverse effects from diuretics do not typically indicate a contraindication to ceftriaxone. While diuretics like furosemide can interact with aminoglycosides to increase nephrotoxicity, ceftriaxone does not share this risk. Monitoring for individual tolerances is important, but this statement does not require holding the medication.

C. "I have a history of hearing problems." Ceftriaxone is not associated with ototoxicity, unlike aminoglycosides or vancomycin. A history of hearing problems does not necessitate withholding the medication, though the nurse should monitor for any new or worsening symptoms if concurrent ototoxic medications are prescribed.

D. "I take prednisone for my asthma." Corticosteroid use does not directly contraindicate ceftriaxone administration. While prolonged corticosteroid therapy may increase the risk of infections or mask symptoms of an allergic reaction, it does not warrant holding the antibiotic. The nurse should continue routine monitoring but can safely proceed with administration.