Which of the following safety measures is most important for the nurse

Which of the following safety measures is most important for the nurse to implement for a hos-pitalized client with a visual impairment?

1. Orient the client to the room.
2. Open the window blinds to let in light.
3. Keep the client’s door to the room open so that he or she can be visualized.
4. Keep all four side rails up to remind the client not to get up on his or her own.

ANSWER

ANS: 1
Clients with serious visual impairment need to feel comfortable in knowing the boundaries of the immediate environment. Normally we see physical boundaries within a room. The blind or se-verely visually impaired often touch the boundaries or objects to gain a sense of their surround-ings. The client needs to walk through a room and feel the walls to establish a sense of direction. Help clients by explaining objects within the room, such as furniture or equipment. It takes time for the client to absorb a room’s arrangement. The client often needs to reorient again, with your explaining the location of key items. Glare from the window may actually cause more visual problems. The client may prefer to have the door to the room closed for privacy. Putting all four side rails up on the bed increases the risk for falls.