A nurse in a long-term care facility is assessing an older adult client for depression. Which of the following findings should the nurse expect?

A. Recent head injury:
A recent head injury is a potential concern when considering the prescription of bupropion. Bupropion can lower the seizure threshold, and head injuries might increase the risk of seizures. Therefore, it's important to report a recent head injury to the healthcare provider to assess the client's suitability for bupropion.

B. Hepatitis B infection:
Hepatitis B infection is not a contraindication for bupropion. However, the healthcare provider should be aware of the client's full medical history, including hepatitis B infection, to ensure appropriate monitoring and management, especially if the client is taking other medications or has liver function concerns.

C. Hypothyroidism:
Hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormones, is not a contraindication for bupropion. However, the healthcare provider should be aware of this condition to monitor the client appropriately, as thyroid function can influence the metabolism of medications.

D. Knee arthroplasty 1 month ago:
Knee arthroplasty (knee replacement surgery) performed one month ago is not a direct contraindication for bupropion use. However, the provider should be informed of recent surgeries or procedures, especially if the client is taking medications or undergoing physical therapy, to ensure there are no potential drug interactions or complications related to the recent surgery. It's essential to monitor for signs of infection or other complications post-surgery.

A. Obtain a prescription for restraints on an as-needed basis:
Restraints should never be used on an as-needed basis without a specific, individualized order from a healthcare provider. Restraints are a significant intervention that should only be used when necessary, and they require a clear prescription outlining the duration, reason, and method of application.

B. Have the provider assess the client within 1 hour after applying the restraints:
This option is the correct choice. It is crucial to involve the healthcare provider promptly after restraints are applied. The provider needs to assess the patient's physical and mental status, and the appropriateness of the restraints, and consider alternatives or modifications to the intervention. Regular assessments ensure the patient's safety and well-being while addressing the initial reason for applying restraints.

C. Request that the provider renew the prescription for restraints every 8 hours:
Restraining a patient every 8 hours without ongoing assessment and a clear clinical rationale is inappropriate and goes against best practices. Restraints should only be used when absolutely necessary and should be reevaluated frequently. Requesting a renewal on a fixed schedule without considering the patient's changing condition is not a safe or ethical approach.

D. Evaluate the client hourly while the restraints are applied:
While regular monitoring of a patient in restraints is essential, evaluating the patient every hour might not be sufficient, especially in the early stages after the application of restraints. The patient should be continuously monitored, with assessments conducted more frequently, especially immediately after applying the restraints, to ensure their safety and well-being.