Which patient has the highest risk of experiencing nocturia? The patient who:

Choice A rationale

Deception involves intentionally misleading someone. Applying physical restraints for the client's safety, while ethically complex, is a transparent intervention intended to prevent harm, not to deceive the client. The intent is protective, even if the client resists.

Choice B rationale

Advocacy involves supporting the client's best interests and rights. While the nurse's concern for the client's safety is a form of advocacy, the act of physical restraint itself can be seen as limiting the client's autonomy, potentially conflicting with a purely advocacy-based approach.

Choice C rationale

Harm, in an ethical context, refers to physical or psychological injury or damage. While the intention of restraints is to prevent falls and physical harm, the application of restraints can itself cause physical injury (e.g., skin breakdown, nerve damage) or psychological distress (e.g., fear, humiliation, loss of control). Therefore, it is a measure that carries the potential for harm.

Choice D rationale

Paternalism involves making decisions for a client that the healthcare professional believes are in the client's best interest, even against the client's wishes. Applying restraints to prevent the client from harming themselves, despite their resistance, aligns with the concept of paternalism, prioritizing safety over autonomy in this specific situation.

Choice A rationale

Identifying factors that interfere with normal sleep patterns is a crucial step in addressing sleep disturbances, but it doesn't directly demonstrate the effectiveness of a plan of care to promote rest and sleep. While understanding these factors can lead to interventions, the actual outcome is reflected in the improvement of sleep quality.

Choice B rationale

Verbalizing an ability to sleep without medications is a positive outcome, but it doesn't solely indicate the effectiveness of a comprehensive plan of care. The quality and duration of sleep are also critical indicators of successful interventions aimed at promoting rest and sleep, beyond just medication independence.

Choice C rationale

Engaging in relaxing activities before bedtime is a helpful strategy to promote sleep, but it is an action taken by the patient, not a direct measure of the plan's effectiveness. The ultimate success of the plan is determined by whether these activities actually result in improved rest and sleep.

Choice D rationale

Reporting improved quality of rest and sleep directly indicates that the plan of care has been effective in achieving its goal. This subjective measure, when consistently reported by the patient, signifies that the interventions implemented have positively impacted their ability to rest and sleep well.