A client is standing in the hallway on the phone arguing with the caller. As the client becomes increasing loud and argumentative, an appropriate action for the nurse to take would be to:
1. Move the other clients away from the area providing the client privacy to continue the conversation.
2. Stand next to the client and say in a calm, firm voice, "If you cannot lower your voice, you will lose your phone privileges indefinitely."
3. Walk up to the client and softly say, "This conversation appears to be getting you upset, tell this person that you will talk later and come sit with me to discuss what is bothering you."
4. Do nothing. The client does not pose any danger as the person the client is angry with is not physically present.
3
Rationale: An underlying goal of initial efforts at de-escalation is to assist the client in getting away from the aversive stimulus and to assess his or her ability to regain control. Encroaching upon the client's physical space and making a demand could escalate the aggression level; moreover, no rights can be restricted indefinitely. Allowing the client to continue to engage in escalating behavior could lead to violence.
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