Chapter 13

Question 1

chemical restraint

Answer 1

drug used for discipline / staff convenience
- not required to treat medical symptoms

Question 2

enabler

Answer 2

device that limits freedom of movement but promotes safety / comfort

Question 3

physical restraint

Answer 3

manual / physical device, material, equipment:
- attached to / near person’s body
- cannot be removed easily
- restricts freedom of movement / access to body part

Question 4

when are restraints used ?

Answer 4

• when less restrictive measures fail
• LAST RESORT

Question 5

when are restraints discontinued ?

Answer 5

as soon as possible

Question 5

restraints should not be used for what two reasons ?

Answer 5

• to discipline
• for staff convenience

Question 6

manual method

Answer 6

hold / limit movement by using body contact

Question 7

remove easily

Answer 7

physical restraint can intentionally be removed by person in same manner restraint was applied
- bed rails, open a buckle, untie knot, etc.

Question 8

why should restraints concerning when used for persons w/ dementia ?

Answer 8

can increase confusion, aggression, agitation,
- induce stroke / death

Question 9

risks from using restraints ?

Answer 9

injuries (trying to get free, applying too tight, etc.)

Question 10

common injuries from restraints ?

Answer 10

• cuts
• bruises
• fractures
• death from strangulation

Question 11

how often should you check up on person w/ restraint ?

Answer 11

every 15 min

Question 12

CMS requires the report of any death within what time frames of restraint usage ?

Answer 12

• while person is restrained
• within 24 hours after restraint was removed
• within a week after restraint was removed

Question 13

what to do when person is strangling due to restraint ?

Answer 13

• release / cut straps if possible
• shout for help and nurse
• stay w/ person
• perform CPR according to guidelines

Question 14

what rules must you follow when using restraints ? (6)

Answer 14

• dr. order is required
• restraint must protect person
• least restrictive method is used
• restraints are only used if all other measures fail
• unnecessary restraint is false imprisonment
• informed consent is required

Question 15

safety guidelines to follow when using restraints ? (5)

Answer 15

• observe person for increased confusion / agitation
• protect person’s quality of life
• must follow manufacturer’s instructions
• observe person at least every 15 min
• remove restraints / reposition / meet basic needs every 2 hours

Question 16

constant observation may be needed for what kind of people ?

Answer 16

• extremely aggressive, agitated, combative
• at risk for aspiration
• at risk for suicide

Question 17

when reposition person w/ restraints, how long are restraints released for ?

Answer 17

at least 10 min

Question 18

if applied to chest / waist how much slack should be allowed between restraint and person ?

Answer 18

flat hand should be able to slide in-between restraint and person

Question 19

where should straps of restraints be secured if used in a bed ?

Answer 19

part of bed frame that moves w/ raising / lowering
- never bed rails, head / foot board

Question 20

where should straps of restraint be secured if used in a wheelchair ?

Answer 20

under the seat

Question 21

how to apply vest restraint properly ?

Answer 21

“V” neck is in front

Question 22

how to apply jacket restraint properly ?

Answer 22

opening is in back

Question 23

how to apply belt restraint properly ?

Answer 23

at 45

Question 24

when wearing vest, jacket or belt restraint in bed, should bed rails be up ?

Answer 24

yes - prevents falling off bed and strangulation

Question 25

should back cushions be used when person is restrained in chair ?

Answer 25

no - movement of cushion can reduce / increase slack (risks strangulation and injury)

Question 26

should person in supine position be monitored more often / constantly ?

Answer 26

yes - high risk of aspiration

Question 27

you should not position a person w/ restraints under what conditions ? (2)

Answer 27

- if on a toilet - if furniture doesn't allow proper application

Question 28

how much space should be left between person's body and limb holder / mitt restraints ?

Answer 28

should be able to slide 1 finger in-between restraint and person's body

Question 29

what material are restraints usually made out of ?

Answer 29

cloth / stronger material

Question 30

limb holders would be used for person's w/ what risks ?

Answer 30

- risk for pulling out treatment tubes (IV, feeding tube, etc.) - risk for pulling at vital sign monitors - scratches at / picks at skin

Question 31

difference between movement allowed by belt restraints and jacket / vest restraints ?

Answer 31

belt restraints allow person to move side-to-side and to sit up; jacket / vest restraints don't

Question 32

what observations of restrained person's you must report at once ? (4)

Answer 32

- difficulty breathing - pain / numbness / tingling in body part restrained - discomfort - restraint too tight