A nurse is assisting with the care of a client.

Exhibits

For each data collection finding, dick to specify if the finding is consistent with ulcerative colitis, diverticulitis, or Crohn's disease. Each finding may support more than 1 disease process.

A. Place the client in a sitting position. A belt restraint should be applied while the client is in a sitting or supine position to minimize the risk of injury and ensure comfort. Proper positioning helps maintain respiratory function and circulation, reducing complications associated with prolonged immobility.
B. Ensure the restraint is placed across the client's chest. A belt restraint should be secured around the waist, not the chest, to prevent respiratory restriction. Placing it across the chest can impair breathing and increase the risk of asphyxiation, especially if the client struggles or shifts position.
C. Tie the restraint to the railing of the client's bed. Restraints should always be secured to the bed frame, never to the side rails, to prevent injury. Attaching restraints to side rails can cause excessive restriction or accidental tightening if the rails are adjusted, leading to discomfort or harm.
D. Apply the restraint under the client's clothes. Restraints should be placed over the client's clothing or gown to prevent skin irritation and pressure injuries. Applying a restraint directly against the skin increases the risk of friction, breakdown, and potential pressure ulcers over time.

A. Inject 15 units of air into the regular insulin vial. When mixing NPH and regular insulin, air is first injected into both vials without touching the solution. After injecting air into the NPH vial, the next step is to inject air into the regular insulin vial to maintain proper vial pressure before withdrawing the dose.
B. Place the cap over the needle. Recapping needles increases the risk of needlestick injuries and is not necessary during the insulin preparation process. The needle should remain uncapped until both insulins are drawn and the injection is ready.
C. Withdraw 10 units of NPH insulin. Regular insulin should be drawn first to prevent contamination with NPH insulin. Since NPH is a cloudy suspension and regular insulin is clear, drawing regular insulin first ensures that the short-acting insulin remains unaltered.
D. Verify the dosage with another nurse. While verifying high-risk medications like insulin is important, the appropriate step after injecting air into the NPH vial is to proceed with injecting air into the regular insulin vial before withdrawing any insulin.