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Skills for RNSG 1105 Questions With Complete Solutions
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Skills for RNSG 1105 Questions With Complete Solutions
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Skills for RNSG 1105 Questions With Complete SolutionsApplying an extremity restraint ( 15 steps) Correct Answer
Equipment needed: cloth restraints, padding for bony
prominences if necessary
Applying an extremity restraint ( 15 steps) (evaluation) Correct
Answer 11. After application, assess the patient for signs of
injury hourly( or every 15 min if the patient is violent) or
according to the facility policy and should include.
Applying an extremity restraint ( 15 steps) (evaluation) Correct
Answer 12. Release restraint every 2 hours, or according to
agency policy and for patients need to toileting, nutrition,
hygiene. Assess extremity and fingers/toes perform ROM as
needed.
Applying an extremity restraint ( 15 steps) (evaluation) Correct
Answer 13. Evaluate patient for continued need of restraint.
Reapply restraint only if continued need is evident and order is
still valid.
Applying an extremity restraint ( 15 steps) (evaluation) Correct
Answer 14. Reassure patient at regular intervals. Provide
continue explanation of rationale for interventions and
reorientation if necessary. Keep call bell within easy reach.
Applying an extremity restraint ( 15 steps) (evaluation) Correct
Answer 15. Document restraint alternatives attempted patients
behavior prior to application type of restraint applied location of
restraint time and assessment.
,Applying an extremity restraint ( 15 steps) (evaluation) Correct
Answer A. The placement of the restraint, neurovascular
assessment of affected extremity. And skin integrity.
B. Assess for signs of sensory deprivation, such as increased
sleeping, daydreaming anxiety, panic, and hallucinations.
C. Readiness for discontinuation
Applying an extremity restraint ( 15 steps) (implementation)
Correct Answer 10. If appropriate, demonstrate use of the call
button and make sure the patient has access to it.
Applying an extremity restraint ( 15 steps) (implementation)
Correct Answer 5. Be sure Pt is in a comfortable position and in
proper body alignment.
Applying an extremity restraint ( 15 steps) (implementation)
Correct Answer 6. Inspect area where restraint is to be placed.
( nearby equipment, tubing, condition of patients skin)
Applying an extremity restraint ( 15 steps) (implementation)
Correct Answer 7. Apply restraint according to manufacturers
directions.
Applying an extremity restraint ( 15 steps) (implementation)
Correct Answer 8. Ensure that two fingers can be inserted
between the restraint and patients wrist or ankle.
Applying an extremity restraint ( 15 steps) (implementation)
Correct Answer 9. Maintain restrained extremity in normal
anatomical position. Use a quick release knot to tie the restraint
, strap to the bed frame, not side rail. The restraint strap may be
attached to chair frame. The site should not be accessible to the
patient.
Applying an extremity restraint ( 15 steps) (implementation)
Correct Answer A. Choose the least restrictive type of device
that allows the greatest possible degree of mobility.
Applying an extremity restraint ( 15 steps) (implementation)
Correct Answer B. Pad bony prominences if needed.
Applying an extremity restraint ( 15 steps) (implementation)
Correct Answer C. Wrap the restraint around the extremity with
the soft part in contact with the skin.
Applying an extremity restraint ( 15 steps) (implementation)
Correct Answer D. Secure restraint with the Velcro straps or
quick release buckle or knot at the extremity, ensure that it does
not tighten around the extremity upon movement.
Applying an extremity restraint ( 15 steps) (Prior to application)
Correct Answer 1. Determine need for restraints. Asses patient
physical condition,behavior ,and mental status(confusion,
disorientation, agitation, repeated removing of tubing or
dressings)
Applying an extremity restraint ( 15 steps) (Prior to application)
Correct Answer 2. Make sure that al alternatives have been tired
prior to use of restraints and determined failure of the alternative
measures.
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