A nurse is caring for a client who has a thoracic spine injury. Which of the following actions should the nurse take when turning the client?

Place a pillow under the client's knees when changing positions.

Use a sheet when repositioning the client onto his side.

Apply an immobilizing collar on the client prior to movement.

Instruct the client to keep his arms at his side when altering positions.

Answer and Explanation

The Correct Answer is B

Rationale:

A. Place a pillow under the client's knees when changing positions: Elevating the knees with a pillow may be appropriate for comfort, but in a client with a thoracic spine injury, this can alter spinal alignment and increase the risk of further injury. Maintaining proper spinal alignment during all movements is more important than knee elevation.

B. Use a sheet when repositioning the client onto his side: Using a sheet for logrolling or turning helps maintain spinal alignment and allows multiple caregivers to move the client safely as a unit. This technique minimizes rotation or flexion of the spine, which is critical in preventing further spinal cord injury in clients with thoracic spine trauma.

C. Apply an immobilizing collar on the client prior to movement: Cervical collars are used for cervical spine injuries, not thoracic spine injuries. Applying a collar would not stabilize the thoracic spine and could give a false sense of security while performing repositioning.

D. Instruct the client to keep his arms at his side when altering positions: The client may need to assist in turning if possible, and keeping the arms rigidly at the side is not necessary. Restricting arm movement does not ensure spinal safety and may limit the client’s ability to participate safely in repositioning.

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Correct Answer is D

Explanation

Rationale:

A. "Store oxygen cylinders on their side.": Oxygen cylinders should always be stored upright and secured to prevent tipping, rolling, or falling, which could damage the valve and create a fire hazard. Storing cylinders on their side increases the risk of accidents and is unsafe in the home setting.

B. "Use two-prong electrical outlets in the room where oxygen is used.": Electrical safety requires that outlets and devices used near oxygen be in good condition and free of sparks. The number of prongs is not the key concern; rather, all electrical equipment should be properly grounded and well-maintained to prevent ignition in an oxygen-rich environment.

C. "You can adjust the flow of your oxygen as needed.": Oxygen flow should only be adjusted according to the provider’s prescription. Changing the flow without guidance can result in hypoxia if decreased or oxygen toxicity if increased, making this statement unsafe and incorrect.

D. "Notify your power company that oxygen is used in the home.": Informing the power company is an important safety measure because home oxygen use increases fire risk. Utility companies can provide guidance on electrical safety, and emergency responders will be aware of the presence of oxygen in case of power outages or accidents.

A. Instruct the client to discard the medication in the toilet. B. Manually break the tablets in half. C. Determine if the tablets are scored. D. Ask the pharmacy to create a liquid version of the medication.

Correct Answer is C

Explanation

Rationale:

A. Instruct the client to discard the medication in the toilet: Disposing of medication in the toilet is not a recommended first action, as it does not address the client’s question about safely taking a half dose. Safe disposal is only necessary for expired or unwanted medications.

B. Manually break the tablets in half: Manually breaking tablets without knowing if they are designed to be split can lead to inaccurate dosing and affect drug efficacy. Some medications are not safe to split due to extended-release properties or uneven distribution of active ingredients.

C. Determine if the tablets are scored: Scored tablets are specifically designed to be split, ensuring accurate dosing. The nurse should verify whether the medication is scored before advising the client to cut it, ensuring safety and effectiveness of the prescribed dose.

D. Ask the pharmacy to create a liquid version of the medication: While a liquid formulation may be appropriate for accurate dosing if the tablet cannot be safely split, the first step is to confirm whether the current tablet can be divided. The pharmacy can then provide alternatives if splitting is unsafe.

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A nurse is caring for a client who has a thoracic spine injury. Which of the following actions should the nurse take when turning the client?

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