Chapter 15: Restraint Alternatives and Safe Restraint Use

The straps of the vest and jacket restrains

A. always cross in the front

When you check a mitt, wrist, or ankle restraint every 15 minutes, tell the nurse at once if you observe these signs or symptoms

A. cannot feel pulse B. numbness or pain C. fingers and toes are cold D. the skin is red or discoloured

When you remove the restraints every 2 hours, what are the basic needs that should be met.

A. measure vital signs B. meet administration needs C. offer food and fluids D. meet hygiene needs E. give skin care F. ROM exercises or help the resident walk G. provide physical and emotional comfort

A restraint is used only when it is the best safety precaution for the person

A. restraints must protect the person

When using a vest restraint in bed

A. the ties are secured to the bed frame out of the person's reach

When using restraints, what information is reported and recorded?

A. the type B. the body part(s) C. reason for application D. safety measures taken up E. time applied F. time removed and for how long G. person's vital signs H. care given while removed and for how long I. skin colour and condition J. pulse felt with restrained part K. condition of limbs L. changes in person's behavior M. i. difficulty breathing ii. pain, numbness, tingling in the restrained part iii. discomfort iv. a tight restraint

Which of these is a physical restraint?

A. vest

When you are delegated to apply restraints, what information do you need from the nurse and the care plan?

A. why doctor ordered restraint B. what type and size C. where to apply restraint D. how to safely apply restraint E. how to correctly position the person F. bony areas to pad and how G. if bed pads or gap protectors are needed H. if bed rails are up or down I. what special equipment is needed J. to check person more or less often than 15 minutes K. when to apply and remove restraint L. observations to report and report M. what to report observations N. patient/resident concerns to report at once

The person who is restrained must be observed every

B. 15 minutes

A roll belt restrains

B. allows the person to turn from side to side

If you do not know hot to apply a restraint, you should

B. ask the nurse to observe you applying the restraint

Restrains may increase

B. confusion and agitation

Restraints are not used to

B. control the person's behaviors

The most serious risk from restrains is

B. death from strangulation

Elbow restraints are used

B. for children to limit movements and prevent scratching and touching incisions

All of these are legal aspects of restraint use except

B. nurses can decide when to use restrains, w hat type of restraints to use, and how long to use the restrains

Restraints are used

B. only to teat a medical symptom or for the immediate physical safety of the person or others

IF you are using padded mitt restraints, you should

B. pad the mitt with soft material

The doctor gives the reason for the restraint, what to use, and how long to use the restrain.

B. restrains require a written doctor's order

Using a restraint requires informed consent. This consent is obtained by

B. the doctor or nurse

Guidelines about using restrains are part of the resident rights in

C. OBRA, FDA, CMS, and TJC regulations

Which of these is a type of restraint?

C. a chair with a tray that prevents the person rom rising

Research shows that restraints

C. cause falls

A belt restraint should be

C. checked to make sure the person is comfortable and in good body alignment

Wrist restrains are used when a person

C. pulls at tubes used in medical restraints

Passive physical restraints are the least restrictive so should be used when possible

C. the least restrictive method of restraint is used

When you check a person in vest, jacket, or belt restraint, report at once if

C. the person is not breathing or is having difficulty breathing

When restraining a combative and agitated person, it should be done

C. with enough staff to complete the task safely and quickly

When applying wrist restrains

D. Place the soft or foam part toward the skin

A person's harmful behaviors may be caused by all of these except

D. being uncooperative with staff

The care plan must include measures to protect the person and to prevent the person from harming others

D. restraints are used only after other methods fail to protect the persons.

IF told to apply a restraint, you must clearly understand the need for restrains and the risks

E. unnecessary restraint is false imprisonment

The person must understand the reason for the restraints.

F. informed consent is required for restraint use.

You are provided the manufacturer's instructions for applying and securing restraints

G. the manufacturer's instructions are followed

Person in immediate danger of harming themselves or others are restrained quickly

H. restraints are applied withe enough help to protect the person and staff from injury

Restrained persons need repeated explanations and reassurance

I. restrains can increase a person's confusion and agitation

Restrains are used for as short a time as possible and needs are met with as little restraint as possible

J. quality of life must be protected

Injuries and deaths have occurred from improper restraint and poor observation

K. the person is observed at least every 15 minutes or more often as required by the care plan

Restraint is removed. Person is ambulated or range of motion exercises are performed

L. the restraint is removed, the person repositioned, and basic needs met at least every 2 hours.

Any action taken to control or manage a person's behavior that requires less effort by the staff is a _____ .

convenience

You should carry scissors with you because in an emergency

cutting a tie is faster than untying one

Any action taken by the agency to punish or penalize a patient or resident is _____ .

discipline

A device that limits freedom of movement but is used to promote independence is an _____ .

enabler

Any change in place or position for the body that the person is physically able to control is called

freedom of movement

An indication or characteristic of a physical or psychological condition is a _____

medical symptom

Any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body, or head freely

physical restraint

_____ is a term used when a manual method device, material, or equipment can be removed intentionally by the person in the same manner it was applied by the staff.

remove easily

Persons restrained in a supine positions must be monitored constantly because they are at great risk for

aspirations

A _____ is any drug used for discipline or convenience and not required to treat medical symptoms.

chemical restraint