A nurse working on a surgical unit is developing a care plan for a client who has paraplegia. The client has an area of nonblanchable erythema over his ischium. Which of the following interventions should the nurse include in the care plan?

Rationale:

• Encourage naps during the day when client is tired: Daytime napping can interfere with nighttime sleep quality and reduce trazodone’s effectiveness in reestablishing a normal sleep pattern.

• Advise client to rise slowly from sitting position: Trazodone can cause orthostatic hypotension, particularly when therapy is initiated. Educating the client to change positions slowly helps prevent dizziness and potential falls caused by sudden drops in blood pressure.

• Instruct client to avoid foods that have been fermented or aged: This instruction applies to MAOIs due to the risk of hypertensive crisis from tyramine, but trazodone is a serotonin antagonist and reuptake inhibitor, not an MAOI.

• Encourage client to sleep until later in the morning: Oversleeping disrupts the circadian rhythm and may worsen fatigue. The goal is to maintain a stable sleep-wake cycle to enhance mood and energy regulation.

• Encourage a regular sleep-wake schedule: Establishing consistent sleep routines supports trazodone’s sedative effects and helps regulate the client’s circadian rhythm, improving overall sleep quality without disrupting normal activity patterns.

• Advise client to notify provider if pregnant: Trazodone is classified as pregnancy category C, meaning potential fetal risks exist. The client should notify the provider to evaluate the safety of continuing or adjusting medication during pregnancy.

• Encourage high-calorie finger foods: The client’s BMI has decreased, and trazodone may cause appetite suppression. Offering convenient, calorie-dense snacks helps maintain adequate nutrition and prevents further weight loss.

Rationale:
A. "Remove a plug from the socket by pulling the cord.": Pulling a plug out by the cord can damage the wiring and expose live electrical components, increasing the risk of electric shock or fire. The plug should always be removed by grasping the base of the plug itself to ensure safety.

B. "Check for a tingling sensation around the cord.": A tingling sensation indicates faulty wiring or electrical leakage, which poses a serious safety hazard. Rather than checking for it, individuals should immediately stop using any cord that gives off a tingling sensation and report or replace it.

C. "Use three-pronged grounded plugs.": Grounded plugs provide an essential safety feature by redirecting excess electrical current safely into the ground. This reduces the risk of electrical fires and shocks, especially in appliances with metal casings or high power consumption.

D. "Cover extension cords with a rug.": Covering cords traps heat, prevents adequate ventilation, and increases the risk of overheating and fire. Extension cords should remain uncovered and placed in areas where they will not be walked on or damaged.