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A nurse is assisting a client who requests to take a tub bath. Which of the following actions should the nurse take?

A.

Check on the client every 10 min during the bath.

B.

Add bath oil to the water after the client gets into the tub.

C.

Drain the tub water before the client gets out.

D.

Allow the client to remain in the bath for 30 min.

Answer and Explanation

The Correct Answer is C

Answer is: Drain the tub water before the client gets out.

Explanation: This is the correct answer because it reduces the risk of slipping and falling for the client, especially if they have limited mobility or balance problems. The other options are incorrect because:

  • Checking on the client every 10 min during the bath is not enough to ensure their safety and comfort. The nurse should check on them more frequently, such as every 5 to 10 minutes, depending on their needs and preferences.
  • Adding bath oil to the water after the client gets into the tub is not a good idea because it can make the water slippery and increase the risk of falling. The nurse should add bath oil to the water before the client gets into the tub, or use a non-slip mat or shower chair.
  • Allowing the client to remain in the bath for 30 min is too long and can cause dehydration, hypothermia, or skin irritation. The nurse should instruct the client to remain in the tub for no longer than 20 min, unless otherwise ordered by a physician.


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Related Questions

Correct Answer is A

Explanation

A. Correct. This situation involves a potential medication error due to the electronic IV pump delivering excessive fluid, which requires documentation and an incident report for reporting and tracking purposes.
B. While observing another nurse's practice is important, the scenario does not involve an incident that requires reporting via an incident report.
C. This situation may warrant a medication incident report, but the family member's administration of PCA might be within their scope if properly trained and authorized.
D. This scenario involves a side effect of a medication, but it is not a situation requiring an incident report unless it is a severe or unexpected reaction.

Correct Answer is B

Explanation

A. Weight loss is a potential side effect of methylphenidate, but it is not a direct indicator of medication effectiveness.
B. Correct. Improved ability to complete tasks like homework can be a positive indication of the medication's effectiveness in managing ADHD symptoms.
C. Increased caloric intake might not be directly related to the medication's effectiveness.
D. "A better grasp of reality" is a vague statement and not a specific indicator of ADHD medication effectiveness.

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