A practical nurse (PN) is preparing morning medications in a substance use detoxification unit. A client approaches the medication window, loudly demands to be discharged immediately, bangs a fist on the counter, and stands aggressively close to another client who is waiting. Which immediate actions should the PN take? Select all that apply.
- Set clear, concise limits regarding the disruptive behaviors using a neutral toneCevap
- Direct the bystander client to safely relocate to the dayroomCevap
- Maintain a physical distance of at least two arm lengths from the agitated clientCevap
- DExplain the facility's step-by-step discharge protocols to help the client understand the delay
- EProvide reassurance that the situation is not a big deal and will be resolved shortly
- FRequest an immediate prescription for a chemical restraint to prevent further escalation
Cevap
The practical nurse should maintain a physical distance of at least two arm lengths, direct the bystander client to safely relocate, and set clear, concise limits using a neutral tone.
Managing an escalating client requires immediate attention to safety and the use of least-restrictive interventions. Relocating bystanders protects other clients, maintaining physical distance protects the nurse, and setting clear, neutral limits provides structure without provoking further aggression.
Adım Adım Çözüm
Anahtar Kavram
Milieu Safety and Verbal De-escalation