A nurse is performing a home safety assessment for a client who has experienced a stroke. Which of the following findings are a safety hazards for them? (Select All that Apply.)

Explanation:

A. "We use an automated dispensing device to track the use of controlled substances."

This is a valid statement. Automated dispensing devices (ADDs) help track the use of controlled substances by requiring users to log in, record transactions, and provide an audit trail of medication access.

B. "You are required to have a second nurse witness disposal of a controlled substance."

Having a second nurse witness disposal of controlled substances is a common practice to ensure accountability and prevent diversion. This statement aligns with safety protocols.

C. “If a client refuses a medication, you can place it in your pocket to administer later."

This statement is incorrect and potentially dangerous. Controlled substances should never be pocketed or carried around for later administration, as this increases the risk of diversion and compromises medication safety.

D. "Activities of the automated dispensing machine will be reviewed periodically."

Reviewing the activities of the automated dispensing machine is an essential part of medication safety and helps detect any discrepancies or irregularities in medication access and administration.

E. "We count the amount of a controlled substance available before removal from a medication drawer."

Counting the amount of controlled substances before removal from a medication drawer is a standard procedure to ensure accurate inventory management and detect any discrepancies or losses promptly.

Explanation:

A. The child was brought to the facility 30 minutes after the injury occurred:

The timing of seeking medical attention alone may not necessarily indicate abuse. However, if there are inconsistencies in the reported mechanism of injury or if there is a delay in seeking medical care without a valid explanation, it can raise suspicion and warrant further investigation.

B. The parents report that the child injured herself by falling off the couch:

While falls are common causes of fractures in toddlers, spiral fractures are more commonly associated with twisting or torsional forces, which can raise concerns about non-accidental trauma. If the reported mechanism of injury does not align with the type of fracture or if there are inconsistencies in the history provided, it may indicate potential abuse.

C. The child begins to cry when her arm is examined by the provider:

It is common for children to cry or show discomfort during a physical examination, especially if they are in pain or feeling anxious. While this finding alone may not indicate abuse, it is essential to assess the child's behavior, pain response, and overall presentation for any additional signs or patterns of abuse.

D. The child's examination shows a single injury:

The presence of a single injury does not necessarily rule out abuse. Abusive injuries can be single or multiple, and the absence of other injuries does not negate the possibility of abuse. It is crucial to consider the context, history, and clinical findings comprehensively when evaluating for abuse.