A nurse is caring for a client who is pregnant.

The nurse is reviewing the client's medical record.
Select 4 findings that indicate a potential prenatal complication.

A. A client who has a PCA for chronic pain following a laminectomy: This client is receiving patient-controlled analgesia (PCA) to manage post-surgical pain. The primary focus is pharmacologic pain control, and occupational therapy is not the first-line intervention for acute post-surgical pain management.

B. A client who has Alzheimer's disease and is experiencing abdominal pain: Occupational therapy focuses on improving functional abilities, mobility, and daily activities rather than addressing acute internal pain such as abdominal pain. Management of this client’s pain would involve medical assessment and treatment rather than OT intervention.

C. A client who has migraines and is experiencing nausea and vomiting: Migraine management is primarily medical, focusing on pharmacologic therapy and symptom relief. Occupational therapy is not indicated for acute episodic pain like migraines with associated nausea and vomiting.

D. A client who has painful hands due to degenerative joint disease: Occupational therapy is appropriate for chronic musculoskeletal conditions like degenerative joint disease. OT can help the client maintain hand function, adapt daily activities, improve fine motor skills, and manage chronic pain through therapeutic techniques and assistive devices.

A. Delegate scheduled checks to assistive personnel: Regular, scheduled checks help monitor clients with moderate dementia for signs of restlessness, wandering, or unsafe behaviors that could lead to falls. Delegating this task ensures consistent supervision and enhances safety.

B. Ensure all the side rails are up when the client is in bed: Raising all side rails can actually increase the risk of injury, as clients with dementia may attempt to climb over them, leading to falls or entrapment. Side rails should be used judiciously and according to safety guidelines.

C. Collaborate with a provider to request PRN standard prescriptions for sedatives: Routine use of sedatives can increase confusion, dizziness, and fall risk in clients with dementia. Nonpharmacologic fall prevention strategies are preferred whenever possible.

D. Keep televisions on around the unit for distraction: Continuous background noise or television can be overstimulating and may increase agitation in clients with dementia, potentially increasing the risk of falls rather than preventing them.