If a patient has a blue, cold, and pulseless hand due to tight restraints, what is the first course of action?

When a patient presents with a blue, cold, and pulseless hand as a result of tight restraints, the immediate priority is to relieve the pressure that is causing impaired circulation. The appropriate first course of action is to remove the restraints and notify the nurse.

Removing the restraints promptly addresses the immediate physical issue of compromised blood flow and can prevent severe complications such as tissue damage or necrosis. Once the restraints are taken off, the nurse can then assess the situation further, provide appropriate medical intervention if necessary, and ensure the patient's safety.

Adjusting the restraints may not ensure sufficient relief of circulation, especially if the restraints are too tight. Leaving the restraints on for further assessment poses a risk to the patient's wellbeing, considering the evident signs of compromised circulation. Notifying the family is important, but it is a secondary concern compared to attending to the patient's immediate physical needs.