A nurse is discussing strategies for cost containment with a group of nurse managers. Which of the following statements should the nurse include?

Choice A reason: Attaching restraints to movable side rails is unsafe, as rail movement can cause injury or loosen restraints. They should be secured to the bed frame, a fixed structure, so this guideline is incorrect and dangerous for restraint protocols.
Choice B reason: Documenting the client’s condition every 15 minutes ensures frequent monitoring for safety, circulation, and skin integrity, per CMS and Joint Commission standards. This prevents complications and supports timely restraint removal, making it the correct guideline.
Choice C reason: Requesting PRN restraint prescriptions is inappropriate, as restraints require specific, time-limited orders based on immediate need. PRN orders lack oversight and risk misuse, so this guideline is incorrect and non-compliant with regulations.
Choice D reason: Applying restraints over clothing can cause discomfort or skin irritation, as direct skin contact with padding is preferred for safety. This guideline is incorrect, as proper application minimizes harm, making it inappropriate for protocols.

Choice A reason: Using gauze to cover an infant’s IV site obscures visualization, delaying detection of infiltration or infection. Transparent dressings are preferred, as infants’ small veins are prone to complications. Gauze increases risk by hiding signs like swelling, critical for early intervention in pediatric IV management.
Choice B reason: Monitoring an IV site every 8 hours is inadequate for infants, who need hourly checks due to small vein fragility and high infiltration risk. Frequent assessment detects complications like phlebitis or extravasation early, ensuring vascular integrity and preventing tissue damage in pediatric patients.
Choice C reason: Inserting an IV in the foot is less preferred, as scalp or hand veins are more accessible and stable in infants. Foot IVs risk dislodgement from movement and may impair circulation, increasing complications like tissue damage, making this a suboptimal choice for IV placement.
Choice D reason: A 24-gauge catheter is ideal for infants, as their small veins require smaller needles to minimize trauma and infiltration. This size ensures adequate fluid or medication delivery while reducing vascular damage, aligning with pediatric IV guidelines for safe and effective venous access.