An older adult client who receives intravenous (IV) fluids is making wide gesticulations with her arms and loudly insulting the nursing staff. Which intervention should the nurse implement to maintain safe, effective nursing care initially?

A. Administer haloperidol for agitation: Antipsychotic medications may be used for severe agitation, but pharmacologic interventions are not the first-line response. Giving haloperidol without assessing underlying needs can mask symptoms of delirium, pain, or other causes. B. Determine the patient's needs: The initial nursing action should focus on assessing possible unmet needs such as pain, urinary urgency, hunger, or discomfort related to IV therapy. Addressing the root cause often resolves agitation without requiring restraints or sedating medications, while ensuring safe, person-centered care. C. Close the door to her room to reduce the noise: Closing the door may limit disruption to others but does not address the patient’s distress or agitation. This approach risks neglecting her underlying needs and could worsen feelings of isolation. D. Apply bilateral upper extremity restraints: Restraints should only be used as a last resort after all other interventions fail, and only if the patient poses an immediate threat to herself or others. Using restraints prematurely can increase agitation, cause injury, and compromise patient dignity.