A nurse is caring for a client who has late-stage Alzheimer's disease and is hospitalized for treatment of the flu. During the night shift, the client is found climbing into the bed of another client who becomes upset and scared. Which of the following actions should the nurse take?
Explanation & Rationale
Choice A Reason:Medicating the patient with antipsychotics is not the first-line intervention for managing this behavior. Antipsychotics should be used cautiously and only when non-pharmacological interventions have failed or if the client poses a danger to themselves or others. Over-reliance on medication can lead to unnecessary side effects and does not address the underlying cause of the behavior.Choice B Reason:Assisting the client to the correct room is the most appropriate and immediate action. Clients with late-stage Alzheimer's disease often experience confusion and disorientation, which can lead to wandering and entering the wrong room. Gently guiding the client back to their own room helps to reduce their confusion and ensures the safety and comfort of both clients involved.Choice C Reason:Moving the client to a room at the end of the hall may not be effective in preventing future incidents and could increase the client's sense of isolation and confusion. It is more beneficial to address the immediate behavior and provide ongoing supervision and support to prevent wandering.Choice D Reason:Placing the client in restraints should be avoided unless absolutely necessary for the safety of the client or others. Restraints can cause physical and psychological harm and should only be used as a last resort. Non-restrictive interventions, such as redirection and supervision, are preferred.