A nurse reviews an immobilized patient's laboratory results and discovers that his/her calcium lab values are abnormally high (Hypercalcemia). Which condition will the nurse monitor for most closely in this patient?

A) Place the bedside table within the client's reach: This is an important safety measure to help prevent falls. By ensuring that the bedside table is within easy reach, the client will be less likely to try to reach for objects outside their immediate area, reducing the risk of falls from overextending or getting up unnecessarily.

B) Teach balance and strengthening exercises: Teaching balance and strengthening exercises is a key preventative measure for older adults at risk for falls. These exercises help improve muscle strength, coordination, and stability, which can significantly reduce the likelihood of falls.

C) Provide information about home safety checks: Providing information about home safety is essential to prevent falls in older adults. This includes advising the patient on eliminating hazards (like loose rugs, clutter, or inadequate lighting) and ensuring that the home environment is conducive to safety. A home safety check is part of creating a fall-prevention strategy.

D) Administer sedative at bedtime: Administering sedatives to older adults, especially those at risk for falls, can increase the likelihood of confusion, dizziness, or impaired coordination, which can lead to falls. This is not a recommended intervention. Non-pharmacologic methods for improving sleep hygiene should be prioritized over sedative medications when possible.

E) Lock beds and wheelchairs when not providing care: Locking beds and wheelchairs when not in use is a fundamental safety measure to prevent accidental movement of the bed or wheelchair. This action reduces the risk of the patient falling out of bed or from a wheelchair if they try to move or shift positions.

A) Slide the patient into the new position: Sliding a patient when repositioning can create shear forces on the skin, which may contribute to skin damage. Shearing can occur when the skin sticks to the surface while the underlying tissues move, leading to increased risk of pressure ulcers. Therefore, sliding is not considered the most effective or safest way to reposition a patient at risk for skin impairment.

B) Place the patient in a 30-degree supine position: Placing the patient in a 30-degree supine position is a good method for reducing pressure on bony prominences and minimizing the risk of pressure injuries. However, while this position is helpful for preventing skin breakdown, it does not address the method of repositioning, which is what is being asked in this question.
C) Utilize a transfer device to lift the patient: Using a transfer device, such as a lift or slide sheet, to lift the patient is the best method for repositioning. This technique helps to reduce friction and shear forces on the skin, providing a safer and more effective way to move the patient without causing damage. Transfer devices also allow for a smoother repositioning, minimizing the risk of skin impairment.

D) Elevate the head of the bed 45 degrees: Elevating the head of the bed to 45 degrees can increase the risk of pressure injuries, especially if the patient is immobile and cannot relieve pressure themselves. This position can also contribute to shear forces as the patient slides downward. It may be appropriate in certain clinical situations, but it does not directly address the method of repositioning.