A nurse teaches a newly licensed nurse about reducing the risk of needlestick injuries. Which of the following instructions should the nurse include?

A.Monitoring blood glucose levels is a metabolic assessment primarily indicated for patients with diabetes mellitus or those receiving parenteral nutrition. Immobility does not directly cause acute fluctuations in serum glucose concentrations in the absence of underlying endocrine pathology. While stress can elevate glucose, it is not a specific indicator of gastrointestinal function or peristaltic efficiency.

B.Vital signs such as heart rate and blood pressure provide critical data regarding the patient's hemodynamic stability and autonomic nervous system response. While significant gastrointestinal distress, such as a bowel perforation or severe obstruction, may eventually cause tachycardia or hypotension, these are late-stage systemic signs. They lack the specificity required to detect early-onset ileus or constipation.

C.Assessing bowel sounds via auscultation is the most direct clinical method for evaluating the mechanical effects of immobility on the digestive tract. Reduced physical activity often leads to decreased peristalsis, potentially resulting in constipation or a paralytic ileus. The presence of hypoactive or absent bowel sounds in all four quadrants specifically alerts the nurse to these common gastrointestinal complications.

D.Oxygen saturation levels reflect the efficiency of pulmonary gas exchange and peripheral tissue perfusion rather than digestive motility. Although severe abdominal distension from an obstruction can secondary impact respiratory excursion by elevating the diaphragm, it is an indirect and non-specific finding. Pulse oximetry is not a diagnostic tool for identifying primary gastrointestinal complications related to a sedentary state.

A.Tilting the head toward the chest misaligns the cervical spine and shifts the center of gravity forward, increasing the risk of strain. Proper body mechanics require keeping the head erect and the neck in a neutral position to maintain spinal equilibrium during heavy lifting. Poor head positioning can lead to secondary muscle tension in the trapezius and upper back muscles.

B.Keeping the knees straight causes the nurse to bend at the waist, which places the entire load on the small muscles of the lower back. This posture significantly increases the risk of vertebral disc herniation and musculoskeletal injury. Nurses must flex their knees and hips to lower their center of gravity and utilize the powerful gluteal and quadriceps muscles for movement.

C.Keeping the back straight ensures that the spine remains in neutral alignment, allowing the weight of the load to be distributed evenly across the vertebral discs. This position prevents the shearing forces that occur when the spine is curved or twisted under pressure. Maintaining a straight back is a fundamental principle of safe patient handling that protects the nurse from chronic lumbar injuries.

D.Loosening the abdominal muscles leaves the lower spine unsupported during a transfer, increasing the likelihood of injury. Tightening the abdominal muscles, often called "bracing," creates internal core stability and protects the lumbar region from excessive strain. A strong, engaged core act as a natural corset that stabilizes the trunk while the legs perform the actual lifting work.