B and J both have Alzheimer's disease. B walks up behind J in the hall and shouts "Move along,
you're blocking the road. I'll take a stick to you.".
J turns around, shakes his fist, and shouts "I know
what you're up to, you're trying to steal my car.". The best action for the nurse to take would be to
a. reinforce reality by telling B that J can walk in the hall, and telling J that B is not
trying to steal his car.
b. ask the medication nurse to give both clients an as-needed dose of neuroleptic
medication.
c. separate and distract them by directing one to go to the day room and taking the
other to the activities area.
d. step between them, saying "Gentlemen, please quiet down. We do not permit
physical violence here.".
C
Separating and distracting prevents escalation from verbal to physical acting out. Neither client loses
self-esteem during this intervention, and medication will probably not be necessary. Stepping
between two angry, threatening clients is an unsafe action, and trying to reinforce reality during an
angry outburst will probably not be successful when the clients are cognitively impaired.
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