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Zorluk: KolayBehavioral Interventions

A practical nurse (PN) is caring for a client on a mental health unit who becomes increasingly agitated, begins pacing the hallway, and shouts at the nursing staff. Arrange the following behavioral interventions in order of priority, from the least restrictive to the most restrictive.

  1. 1Verbally engage the client in a calm, non-confrontational manner to discuss their feelings.
  2. 2Escort the client to a designated quiet room to reduce environmental stimulation.
  3. 3Administer a prescribed as-needed (PRN) oral antianxiety medication.
  4. 4Apply prescribed physical mechanical restraints to prevent imminent harm.

Cevap

The correct order from least to most restrictive is: verbally engaging the client calmly, escorting the client to a quiet room, administering an oral antianxiety medication, and applying physical mechanical restraints.
In behavioral health, interventions must always progress from the least restrictive to the most restrictive to protect client rights and dignity. The standard hierarchy dictates starting with verbal techniques (calming communication), progressing to milieu/environmental modifications (quiet area), then utilizing pharmacological interventions (oral or injectable medications), and finally using physical restraints only when all other options have failed and there is an immediate threat to safety.

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1
Identify the least restrictive intervention.
Verbally engage the client in a calm, non-confrontational manner to discuss their feelings.
Verbal de-escalation respects the client's autonomy and physical freedom, making it the first line of intervention for an agitated client.
2
Determine the next intervention if verbal de-escalation is insufficient.
Escort the client to a designated quiet room to reduce environmental stimulation.
Environmental modification helps de-escalate the situation by removing triggers, which restricts movement slightly more than verbal techniques but avoids chemical or physical force.
3
Identify the third intervention in the hierarchy of restrictiveness.
Administer a prescribed as-needed (PRN) oral antianxiety medication.
Chemical restraints (medications) alter the client's physiological state and are considered more restrictive than environmental changes, though oral routes are less invasive than injections or physical restraints.
4
Identify the most restrictive intervention.
Apply prescribed physical mechanical restraints to prevent imminent harm.
Physical restraints completely restrict a client's movement and autonomy. They are legally and ethically the absolute last resort.

Anahtar Kavram

Least Restrictive Intervention Hierarchy
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Behavioral Interventions

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