Question

12. A nurse in a long-term care facility determines the need to place a vest restraint on a patient. The patient does not want the vest restraint applied. What nursing action should be implemented?

a. Apply the restraint anyway.
b. Call the physician and obtain an order for the restraint.
c. Medicate the patient with a sedative and then apply the restraint.
d. Compromise with the patient and use wrist restraints.

Answer 1

The nurse should consider the patient's rights and ethical issues surrounding the use of restraints, seek a physician's order, and assess for less restrictive measures to ensure the patient's safety, while respecting their autonomy. The correct option is d. Compromise with the patient and use wrist restraints.

Step-by-step explanation:

The appropriate nursing action when a patient in a long-term care facility refuses a restraint should prioritize respecting the patient's autonomy and dignity while exploring alternative interventions to address the safety concerns. Therefore, the best action is:

d. Compromise with the patient and use wrist restraints.

However, it's essential to assess the situation thoroughly, explore alternative methods to ensure the patient's safety, and consider less restrictive measures before resorting to any form of restraint. If possible, communicating with the patient and involving them in the decision-making process about their care plan is crucial. Using wrist restraints, if agreed upon as a compromise, might be considered less restrictive than a vest restraint while still addressing safety concerns, but this should be done after all other alternatives have been explored and documented accordingly in the patient's care plan.