A 3-year-old preschooler is hospitalized for asthma exacerbation and is on continuous albuterol nebulization. The nurse is planning safety interventions for this patient. Which safety measure is the MOST important priority for this hospitalized child?
1Place the child in a high chair during meals to prevent choking
2Keep the room temperature cool to prevent overheating
3Ensure crib rails are raised and locked at all times when the child is unattended✓ 정답
4Provide age-appropriate toys to prevent boredom and agitation
해설
The most critical safety priority for a hospitalized toddler is fall prevention through proper crib rail management, as toddlers have increased mobility but lack safety awareness. Other options address important but less immediate risks.
Clinical Judgment
This question assesses safety priority setting. A 15-month-old toddler has a very strong urge to move and explore independently due to developmental characteristics, but lacks the cognitive ability to recognize or predict danger. The hospital environment is filled with unfamiliar beds and equipment, sharply increasing the risk of falls. Therefore, fall prevention is an absolute priority over all other safety considerations. Option 3 is the intervention that most directly and reliably controls this risk.
Memory TipFalls are First for Free-moving toddlers. Remember the ABCs of toddler safety: Always Bed Check.
KR vs US
In Korean hospitals, family members often stay with the patient and provide care, so bed rails may not always be kept up. However, in the U.S., patient safety is the top legal and ethical priority, and bed safety is strictly managed under the nurse's independent responsibility. Standard safety protocols must be followed regardless of the presence of a caregiver.
임상 시나리오
Clinical Practice Guide
Safety checklist for the bed of a hospitalized infant: 1) The bed rails are always raised to their highest position, 2) Check that the gap between rails is 2.375 inches (about 6 cm) or less (to prevent the head from slipping through), 3) Double-check that the rail locking mechanism is properly secured, 4) Ensure there are no objects around the bed, such as chairs or tables, that the infant could use to step up and climb on.
Caution
In SATA (Select All That Apply) questions that ask for the "MOST important priority," all options may be correct interventions, but you must choose the one that prevents the most dangerous outcome (e.g., serious injury, death). Interventions focused on "alleviation" rather than "prevention" are lower priority.
핵심 개념
Fall Prevention (낙상 예방) — All interventions to prevent injuries from falls in patients, especially infants, the elderly, and those with impaired motor function. This is one of the top priorities for inpatient safety.
Developmental Stage (발달 단계) — Predictable stages of physical, cognitive, emotional, and social changes that occur during a child's growth process. Nursing interventions should be planned according to the child's developmental stage.
Crib Safety (유아 침대 안전) — Managing the height, spacing, locking devices, and mattress position of crib rails to prevent risks such as falls, entrapment, and suffocation when using a crib.
Toddler (걸음마기 유아) — Typically a child between 1 and 3 years old, this is a developmental stage where they begin to walk independently, experience rapid language development, and show strong curiosity and a pursuit of autonomy.
Safety Priority (안전 우선순위) — Determining which safety risk to address first in patient care, considering both the likelihood of occurrence and severity. In NGN, this is a key element for assessing risk evaluation and clinical judgment skills.