A nurse on a mental health unit is caring for a client who is in restraints. Which of the following actions should the nurse take?

1. Release the client's restraints every 4 hr.
2. Check the client's status every hour.
3. Document the client's behavior leading to the initiation of the restraints.

Obtain written consent by the client for the placement of the restraints.

Elevating the head of the bed while sleeping is a recommended strategy for managing GERD (gastroesophageal reflux disease). By raising the head of the bed, gravity helps to prevent stomach acid from flowing back into the esophagus, reducing the likelihood of acid reflux and associated symptoms.

"You should eat three large meals and two snacks per day" is not recommended for GERD management. Instead, it is advised to have smaller, more frequent meals throughout the day to reduce the pressure on the stomach and minimize the likelihood of acid reflux.

"You should lay down for 1 hour following a meal" is not recommended for GERD management. It is advised to avoid lying down immediately after meals, as this can increase the risk of acid reflux. It is generally recommended to wait at least 2 to 3 hours before lying down.

"You should only drink 2 cups of coffee per day" is a specific recommendation related to caffeine intake, which can potentially trigger or worsen GERD symptoms in some individuals. However, this statement alone does not encompass the comprehensive dietary recommendations for managing GERD.

Explanation:

Displacement is a defense mechanism in which an individual redirect their emotions or impulses from their original target to a less threatening or safer target. In this scenario, the client yells at the nurse when medication changes are prescribed by the provider. The client may be feeling angry or frustrated about the medication changes but is unable to express those emotions directly towards the provider. Instead, the client displaces those feelings onto the nurse, who may be seen as a safer or more accessible target. The yelling behavior directed at the nurse is a way for the client to release and express their emotions indirectly.

Let's briefly discuss the other defense mechanisms mentioned:

A- Conversion: Conversion involves the expression of psychological distress or conflict through physical symptoms or ailments. It is not applicable in this scenario since the client's behavior does not involve physical symptoms.

B- Splitting: Splitting is a defense mechanism characterized by a black-and-white thinking pattern, where individuals perceive others or situations as all good or all bad. It does not directly apply in this scenario as the client's behavior is not indicative of splitting.

D- Sublimation: Sublimation is a defense mechanism in which an individual channel their unacceptable or potentially harmful impulses into socially acceptable outlets, such as creative or productive activities. It is not evident in this scenario as the client's behavior does not involve transforming the emotions into a more positive or socially acceptable form.