The nurse is caring for a client with a history of schizophrenia, alcohol abuse, bipolar disorder, and noncompliance with treatment and medications. The client has also been arrested in the past for violent behavior. Which action by the nurse is the most important when caring for a potentially violent client?

treat the client with courtesy and respect always maintain an open pathway to the door be sure the client swallows his pills and does not “cheek” them ask permission from the client before drawing blood or performing other invasive procedures

When caring for mentally unstable or possibly violent clients, staff safety is the primary concern. The nurse should avoid getting blocked into a corner between the client and the door. If possible, the client should be in a room near the nurses’ station, and the nurse should notify someone else before he enters the room. Taking another nurse or client care technician when entering the room is another way to maintain safety. All clients should be treated with courtesy and respect, especially someone who may be prone to paranoia. It may be necessary to observe the client closely for “cheeking” pills instead of swallowing them. Some medications may be ordered in IV form in order to ensure that the client receives the medication if he has surreptitiously avoided swallowing pills in the past. Always ask permission before touching or approaching the client to avoid startling him. If the client refuses medications or blood draws, do not argue. Chart the refusal in the medical record and notify the health care provider.