A Confused Patient Is Restless and Continues to Try to Remove

question 33

Multiple Choice

A confused patient is restless and continues to try to remove his oxygen and urinary catheter.What is the priority nursing diagnosis and intervention to implement for this patient?

• A) Risk for injury: Prevent harm to patient, use restraints if alternatives fail.
• B) Deficient knowledge: Explain the purpose of oxygen therapy and the urinary catheter.
• C) Disturbed body image: Encourage patient to express concerns about body.
• D) Caregiver role strain: Identify resources to assist with care.

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