24. In attempting to reduce acting-out behaviors by a child in a pediatric psychiatric unit, a brief therapeutic hold is implemented. An RN knows that a therapeutic hold means:
24. In attempting to reduce acting-out behaviors by a child in a pediatric psychiatric unit, a brief therapeutic hold is implemented. An RN knows that a therapeutic hold means:
. Involuntary confinement of a child in a locked room for no more than 30 minutes.
. Physically holding a child, up to 30 minutes, to assist the child to calm down.
. Placement of a papoose-like device on a child who is out of control and acting out.
. Use of a padded room to confine a child who cannot behave in the therapeutic milieu.
Test-Taking Tip
Note the key word "hold"; all other responses relate to confinement.
Content Area: Mental Health, Child Health—Restraint, Acting Out; Integrated Process: Nursing Process, Implementation; Cognitive Level: Comprehension; Client Need/Subneed: Safe and Effective Care Environment/Safety and Infection Control/Use of Restraints/Safety Devices
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Answer 1 is incorrect because this is not therapeutic and can place the client at a risk for injury if left unattended in a room by self. Answer 2 is correct as this is a desired and recognized therapeutic pediatric hold. The nurse implements this type of hold when a client is acting out and in danger of hurting self or others. The therapeutic hold is brief—no longer than 30 minutes—and is used specifically to calm down a child who is out of control. Answer 3 is incorrect because this type of hold is dangerous and has been found to lead to asphyxiation (e.g., restricting respirations). Answer 4 is incorrect because it is not considered a therapeutic hold; rather it is confinement to a designated area and not effective to help calm a client.