Questions: Patient Cheska complained of a persistent cough of 3 weeks with blood. The physician ordered her to under a bronchoscopy to rule out the underlying cause. She received intravenous sedation for the procedure. You received this patient still sedated and not yet fully awake. Your nursing goal for Cheska is to provide safety by: Make sure to attach a 12-lead ECG on Cheska Raise the side rails to prevent falls in the case of sudden seizures Prepare the chest drainage set and have it ready at the bedside in case a sudden respiratory arrest occurs Activating aspiration precaution: you must ensure that food or fluids are not within her reach

The answer is the second one: Raise the side rails to prevent falls in the case of sudden seizures.

Explanation for each option:

1. Make sure to attach a 12-lead ECG on Cheska:

   • This option is not directly related to providing immediate safety for a sedated patient. While monitoring heart activity is important, it does not address the primary concern of preventing physical harm due to sedation.

2. Raise the side rails to prevent falls in the case of sudden seizures:

   • This is the correct answer. Raising the side rails is a standard safety measure for sedated patients to prevent falls and injuries. Sedation can impair a patient's ability to move safely, and side rails provide a physical barrier to prevent accidental falls.

3. Prepare the chest drainage set and have it ready at the bedside in case a sudden respiratory arrest occurs:

   • This option is more specific to a situation where there is a known risk of respiratory complications. While it is important to be prepared for emergencies, the immediate safety concern for a sedated patient is preventing falls and injuries.

4. Activating aspiration precaution: you must ensure that food or fluids are not within her reach:

   • While aspiration precautions are important, especially for patients with impaired consciousness, the immediate safety concern for a sedated patient is to prevent falls. Ensuring that food or fluids are not within reach is secondary to preventing physical harm from falls.

Summary: The primary nursing goal for a sedated patient like Cheska is to ensure her safety by preventing falls. Raising the side rails is the most appropriate and immediate action to achieve this goal.