The nurse is caring for a client with dementia who has pulled out three peripheral IVs. Which intervention by the nurse is the best way to manage this client?

  1. place the client in restraints or mitts
  2. tell the family that they need to stay with the client
  3. replace the IV and wrap it in gauze to hide it from view
  4. tell the client that if she pulls another IV out, she will have to have a PICC line placed
Number 3 is correct.
Rationale: Many clients with dementia pull out an IV because they see it and know that they don’t normally have one. Placing the IV in an inconspicuous place, such as where it can be covered by the gown or wrapped up in gauze, prevents the client from pulling it out, because he cannot see it. Restraints should not be the first-line intervention for this client, as this may increase confusion and agitation. If the family can stay with the client, they can help watch, but many clients do not have family close by that can stay with them around the clock. Threatening the client with a more invasive procedure should never be used as a means of obtaining cooperation.