An older adult client has become agitated and combative toward the health care personnel on the unit. What is the first action that the nurse should take at this time?
A. Obtain an order for a sedative-hypnotic medication to reduce combative behavior.
B. Attempt to soothe the client's fears and reorient the client to his or her surround-ings.
C. Obtain an order to place the client's arms in restraints to protect personnel.
D. Arrange for the client to be transferred to a mental health facility.
B
Restraints, both physical and chemical, may be overutilized in certain circumstances. Seda-tive-hypnotic drugs may have adverse effects in older adults and should be used sparingly. Phys-ical restraints also can have serious repercussions. Transfer to a mental health facility requires evaluation by psychiatric staff and may not be appropriate here. The nurse should establish a trusting relationship with the client, soothe the client's fears, and reorient the client to the facility before resorting to physical or chemical restraints.
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