The type of restraints to prevent the patient pulling a catheter, IV lines and Hair etc?

KPSC Staff Nurse - 2017

Nursing Foundation

Easy

Appeared in: KPSC Staff Nurse - 2017

Explanation

Mitten restraints are specifically designed to cover the hands, preventing the patient from using their fingers to grasp or pull.
As shown in the image, the device encloses the hand in a padded mitt, making it impossible to manipulate tubes, lines, or catheters.
This type of restraint is indicated for patients who are confused, agitated, or disoriented and are at risk of disrupting essential medical treatments.
It is considered a less restrictive option compared to wrist or ankle restraints because it allows for more freedom of arm movement.

Option A: Elbow restraints immobilize the elbow joint, preventing it from bending, but do not restrict hand or finger movement. The patient could still pull at lines with their hands.
Option C: A clove hitch is a type of knot, not a restraint device itself. It is an outdated and unsafe method for securing restraints as it can tighten and cut off circulation.
Option D: Boots are applied to the feet and ankles, not the hands. They have no role in preventing a patient from pulling on lines with their hands.

Clinical Relevance

Nursing practice connection: Use the key finding related to Types of physical restraints and their specific clinical applications to guide bedside assessment, documentation, and the next nursing action.
The principle of 'least restrictive' is paramount in patient safety. Nurses must always try alternatives (e.g., distraction, reorientation, covering lines) before applying any physical restraint.
Improper use of restraints can lead to serious complications, including skin breakdown, nerve damage, circulatory impairment, and psychological distress. Regular and thorough assessment is non-negotiable.
A physician's order is mandatory for applying restraints and must be renewed regularly (e.g., every 24 hours) according to facility policy. Restraints can never be ordered 'as needed' (PRN).

How to Approach the Question

First, identify the core problem described in the question: the need to stop a patient from 'pulling' on lines.
Analyze the action of 'pulling'. This action requires the ability to grasp with fingers and hands.
Evaluate each option based on its mechanism of action. Ask yourself: 'How does this restraint work?'
Option A (Elbow) restricts the elbow, not the hand. Option D (Boots) is for feet. Option C (Clove hitch) is a knot, not a device.
Option B (Mitten) directly addresses the problem by covering the hand and preventing grasping.
The image confirms the appearance and function of a mitten restraint, reinforcing it as the correct choice.

Concept Tested & Keywords

Concept Tested: Types of physical restraints and their specific clinical applications.
Stem keywords: restraints, pulling, catheter, IV lines
Lead-in keywords: type of
Clinical cues: The key action to prevent is 'pulling', which involves grasping with fingers.

QWe4TxB4L4RvU4O3H8YXHi

E6 Nursing Fundamentals Taylor p. 272-274

E6 Nursing Fundamentals Potter Perry 12e Part 2 pp. 208-210, 195-197