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4.39.ID: 383718182Which of the following points should the nurse include when documenting information about a client who is wearing wrist restraints? Select all that apply.A.The client’s temperature B.The client’s 24-hour urine output C.Skin integrity of the restrained body part Correct
D.The procedure used in applying the restraint CorrectE.The date and time of application of the restraint CorrectF.Circulatory and neurovascular status of the restrained extremities CorrectRationale: The nurse is responsible for documenting specific information about the client who is wearing any type of restraint. The points that must be included in such documentation are the reason for the restraint; alternatives to the restraint that were used; the method of restraint; the procedure used in applying the restraint; date and time of application of the restraint; client's response to application of the restraint; condition of the restrained body part; assessment of circulatory, neurovascular, and skin integrity; periodic release from restraint with movement or range-of-motion exercise; assessment of the need for continued use of the restraint; the durationof use of the restraint; and the client's response on removal of the restraint.Awarded 1.0 points out of 1.0 possible points. 5.40.ID: 383717497The nurse plans to wear this protective mask (see figure) when caring for clients with certain disorders. What are these disorders? Select all that apply.