A nurse is caring for a client who reports difficulty falling and remaining asleep. Which of the following actions should the nurse take to promote sleep?

A. Extension cords placed under area rugs: Placing extension cords under rugs creates a fire hazard and increases the risk of electrical shock. It can also cause trips and falls if the cords shift or become damaged, making it an unsafe environmental practice.

B. Refrigerator temperature is 3.3° C (38° F): This temperature is within the recommended safe range for storing perishable food, helping prevent bacterial growth. It does not pose a safety hazard.

C. Covers placed on unused electrical outlets: Outlet covers prevent children from inserting objects into outlets, reducing the risk of electrical shock. This is considered a positive safety measure, not a hazard.

D. A lamp plugged directly into a wall outlet: Plugging a lamp directly into a wall outlet is standard and safe when the outlet is not overloaded. It does not present a hazard under normal use.

Rationale

• Irrigate indwelling urinary catheter with 50 mL normal saline: Following perineal prostatectomy, bladder spasms, pink urine, and a sensation of fullness can indicate catheter blockage from clots. Gentle irrigation with a small volume ensures catheter patency and relieves obstruction. The client’s decreasing urine output despite increased intake further supports the need for irrigation. Restoring flow prevents retention and reduces discomfort from bladder spasms.

• Apply warm compresses to the incision site: Heat increases vasodilation and can worsen postoperative bleeding in a highly vascular perineal area. A prostatectomy incision requires protection from excessive warmth to reduce hemorrhage risk. Additionally, warm compresses could increase swelling and discomfort.

• Maintain bed rest for 2 days postoperatively: Early ambulation is essential to prevent postoperative complications such as DVT, which is especially important given the client’s history of thrombosis. This client is already independently ambulating, which should be encouraged. Bed rest would increase clot formation risk and impair bowel function, worsening constipation and pain.

• Place a blanket roll under the client’s knees while in bed: Placing pillows or rolls under the knees promotes venous stasis and increases DVT risk, which is dangerous for this client with a past history of thrombosis. Knee flexion also strains the perineal surgical area and may increase pain. Maintaining legs flat encourages optimal circulation and reduces risk of clot formation.