Doubt about a question

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i was studding fundamentals of nursing and this question came up:

the client requests to get out of bed to go bathroom. he has orders for "up ad lib". what action do you take?

1.tell him its not good idea and provide urinal

2. ask for the nursing assistant to assist him to the bathroom

3. give him some slippers, and tell him where the bathroom is located.

my answer: [color=#b22222]thinking that up ad lib means the pt can do as much exercise he wants i choose answer number 3.

the correct answer is number 2

why???? does someone understand???

healp pls=)

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Specializes in Psych & Gero psych.

Up ad lib can get up as they want. So "C"

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Specializes in Nephrology, Oncology.

I would have chosen answer #2. You're right in that "up ad lib" means he has privileges to get OOB when desired.

#1 Is brushing off the patient's concerns, when clearly he can, and has orders, to get up to go to the bathroom.

#3 To me is almost like "passing the buck," but to the PT himself; you're giving all the responsibility to the PT. It's an assumption that the PT has good balance, can see where he's going, etc., but the stem of the question doesn't clarify that nor does the answer choice indicate that the nurse has assessed the PTs abilities. Just because a PT has an "up ad lib" order doesn't mean the PT can safely ambulate by himself without help.

#2 Is the delegation answer. It's within the scope of practice of the CNA to help a PT to the bathroom and it ensures client safety. PT safety is huge, especially since the stem of the question isn't assuring you whether or not the PT is completely steady on his feet.

Hope that helped. Good luck with your studies. :nurse:

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Specializes in Psych & Gero psych.

I see your point? But the patient has been evaluated to get up ad lib. And gets assesed every shift. So There's up ad lib with assist. For that. A CNA can't assess they can only assist, so if it said nurse were to assist I would go for it so she could assess as she assists. Otherwise I'm sticking with "C"... But perhaps every floor and hospital is different.

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I would have chosen #2 as well. In both hospitals that I've worked at we had to assist patients even with up ad lib orders unless they had specific orders for stand by assist only.

The problem did not state that they were independent.

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Specializes in Infusion Nursing, Home Health Infusion.

This question will help you in the future to answer other nursing questions. You can only work with the information provided in the question. There is no information provided that tells you the patient is safe to get up by himself it just says up ad lib..as tolerated. Do you know the patient can tolerate it and not fall, No you do not b/c it does not tell you any other information in the question. My nursing brain started asking questions..did he have surg..how old is he...an he get up without assistance oops no info provided.........must say "2"

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Welcome to AN! The largest online nursing community.

I would have started this with we are happy to help with homework but we won't do it for you. We will lead you to the source so you can develop your critical thinking skills that are so imperative to being a good nurse.

The first thing one should do is to look up what ad lib means. Then develop and use our deductive reason/critical thinking skills to find the answer ourselves.

Ad libitum is Latin for "at one's pleasure"; it is often shortened to "ad lib" (as an adjective or adverb) or "ad-lib" (as a verb or noun).

I am really annoyed and sad that latin terms aren't taught in school anymore. I hope this helps explain which of the answers so nicely supplied to you is correct.

I wish you the best :D

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Thank you very much, it healp me a lot :up:

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Ad libitum is Latin for "at one's pleasure"; it is often shortened to "ad lib" (as an adjective or adverb) or "ad-lib" (as a verb or noun).

I did learn the Latin for this in school, but I'm unclear what about the question stem tells you that it is "at one's pleasure" with assistance?

Some AN responses seem to suggest that the patient has "concerns" that the nurse would not want to dismiss by simply telling the patient where the restroom is, but that seems like that is reading into the question as it doesn't say that the patient requested assistance, but rather "request[ed] to get out of bed to go to the bathroom." Couldn't that equally mean that the patient didn't know that he is allowed to get up without assistance? (Which if I assume that, I am also "reading into" the question.)

Other responses seemed to suggest that I must assume the patient requires assistance unless the orders specifically state that the patient is independent OOB ad lib. Is that type of assumption/"reading into" acceptable because that is the safest option?

In real life, I wouldn't do any of the answer choices without additional information.

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Any time an answer will keep a patient safe it always trumps the other "right" answer. Those questions used to always get me. Normally, that's how I also narrow down priority questions if I am stuck between 2 answers!

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Specializes in Trauma Surgical ICU.

Always keep in mind what will keep the pt safe. Test questions can be tricky like that because they don't give you all the details, so with the info you have, which answer is the safest..Not knowing if he is able to stand alone, has had surgery, need help with balance etc. the safe thing is to get him up with assistance.The question did not give you any info about his condition, age, hx etc. The pt could have been a fresh post op getting up for the first time, or a stoke pt with left sided weakness, even if the pt had no disabilities, you would still want to be there at first to assess that on your own..

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I did learn the Latin for this in school, but I'm unclear what about the question stem tells you that it is "at one's pleasure" with assistance?

Some AN responses seem to suggest that the patient has "concerns" that the nurse would not want to dismiss by simply telling the patient where the restroom is, but that seems like that is reading into the question as it doesn't say that the patient requested assistance, but rather "request[ed] to get out of bed to go to the bathroom." Couldn't that equally mean that the patient didn't know that he is allowed to get up without assistance? (Which if I assume that, I am also "reading into" the question.)

Other responses seemed to suggest that I must assume the patient requires assistance unless the orders specifically state that the patient is independent OOB ad lib. Is that type of assumption/"reading into" acceptable because that is the safest option?

In real life, I wouldn't do any of the answer choices without additional information.

Agreed....without asking a thousand questions and having certain facts clarified ...to me the question can't be answered. I see the answer is 2....I disagree. If the guy is really ad lib.......help him with the slippers and move on.

For school? ask the aide to help and move on. Delegation/safety first

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