A physician orders short-term restraints for an elderly patient. ...

[Sufayan.ah]

A physician orders short-term restraints for an elderly patient. The nurse has the responsibility to do all of the following except
 
  a. Remove the restraints periodically
  b. Assist with range-of-motion exercises
  c. Delay following the physician's instructions and contact the interdisciplinary team (IDT)
  d. Observe and care for the skin periodically

Question 2

Validation groups and reality orientation groups are designed for residents experiencing confusion or malorientation. Which of the following statements is true regarding validation and reality orientation?
 
  a. Validation deals with feelings, and reality orientation presents problem solving
  b. Resolving loss is a goal of validation therapy, and keeping older adults oriented to their environment is the goal of reality orientation
  c. Validation confronts the older adult to express feelings of anger and resentment, and reality orientation places those feelings in the reality of today
  d. Validation is a feel good approach for the caregiver, whereas reality orientation helps the resident feel better

[nixon_s]

Answer to Question 1

C
The nurse cannot refuse to obey the physician's orders. After placing the restraints on the patient, as ordered, the nurse may discuss the situation with the supervisor or IDT if he or she seriously disagrees with the physician's assessment. While the restraints are on the patient, the nurse must monitor the patient closely, observe for skin irritations, remove the restraints periodically, and assist with range-of-motion exercises.

Answer to Question 2

B
Validation groups and reality orientation groups are often seen as opposing ways to address confusion in older adults. Reality orientation attempts to reorient residents to the environment. Validation groups work to help residents express feelings and work through resolution of feelings without reality as a criterion. Responses A, C, and D are incorrect.