A nurse is discussing risk factors for child maltreatment with a newly licensed nurse. Which of the following examples should the nurse include?

Rationale:

A. "We will keep the number for poison control stored in our phones.": Having the poison control number readily accessible is a key component of home safety for toddlers, who are at high risk for accidental ingestion. Prompt access supports rapid emergency response and guidance.

B. "We will make sure our hot water heater is set to 54° C (129° F)": This temperature setting is too high and increases the risk of scald burns. Water heaters should be set at or below 49° C (120° F) to reduce the chance of accidental burns during bathing or handwashing.

C. "We will make sure to turn pot handles towards the front of the stove.": Turning pot handles to the front makes them easier for a toddler to grab, increasing burn and injury risk. Handles should always be turned toward the back or center of the stove to keep them out of reach.

D. "We will store medications on a high surface that our child can't reach": High surfaces are not secure enough, as toddlers may climb. Medications should be stored in locked cabinets to ensure they are completely inaccessible to curious children.

Rationale:

• Write the full date on the client's whiteboard: Writing the date helps reinforce orientation to time, which the client is lacking. Visual cues are essential for reorienting clients with delirium. This simple step can reduce confusion and distress.

• Acknowledge the client's feelings: Acknowledging the client’s fear builds trust and therapeutic rapport. It reduces agitation and reassures the client when they experience hallucinations. Validation helps calm the client without reinforcing delusions.

• Request that the client's family bring the client's eyeglasses from home: Requesting the glasses improves the client’s ability to recognize surroundings. Visual impairment worsens confusion in older adults. Familiar visual aids reduce cognitive strain.

• Request that the client have the same caregivers with every shift: Consistent caregivers help the client form familiar relationships. Continuity reduces confusion, especially in clients with dementia or delirium. Routine and predictability lower anxiety.

• Reorient the client often: Frequent reorientation is key in delirium management. It helps the client regain understanding of time, place, and situation. Repetition promotes memory and reduces disorganized thoughts.

• Ask the client's partner to stay with the client as much as possible: The partner provides emotional comfort and familiarity. Their presence helps maintain the client’s orientation and decreases agitation. Family members often support communication and reorientation.

• Provide the client with information about what to expect during their care: Detailed information may overwhelm or confuse a delirious client. Cognitive overload can worsen disorientation. Simpler, brief explanations are more effective.

• Maintain a well-lit environment: Bright lighting may worsen hallucinations or cause overstimulation. Soft, ambient lighting is better suited for reducing visual misperceptions. Delirious patients benefit from calm, low-stimulation environments.