A client in the psychiatric unit's dayroom is becoming agitated, talking incessantly, and starting to yell and swear at the other clients. Which action should the practical nurse (PN) implement first?

Taking a rectal temperature requires a higher level of skill and carries a higher risk of injury compared to other methods, especially when dealing with a 2-year-old child with leukemia. Given the client's condition, it is important to minimize any potential harm or discomfort. Taking a tympanic temperature is a safer alternative that provides an accurate reading without the risk of injury.
B. Reminding the UAP to lubricate the thermometer before insertion is not appropriate because the PN should not encourage or support the UAP in performing a rectal temperature on a high-risk client. The focus should be on using a safer and less invasive method.
C. Instructing the UAP to report the results to the PN immediately is not necessary in this situation because the PN has already determined that taking a rectal temperature is not appropriate.
Instead, the PN should guide the UAP toward using the tympanic method.

D. Observing the UAP to ensure the thermometer is inserted correctly is not appropriate in this case because the PN has already determined that taking a rectal temperature is not the recommended course of action. It is more appropriate to redirect the UAP to use an alternative method.

1. A 12-year-old child with a history of asthma is wheezing and complaining of shortness of breath. Wheezing and shortness of breath indicate respiratory distress, which can be a medical emergency for a child with asthma. Prompt intervention and assessment of the child's respiratory status are crucial.
2. A 7-year-old child who has type 1 diabetes mellitus is experiencing extreme hunger and shakiness. These symptoms may indicate hypoglycemia, which requires immediate attention to prevent further complications. The PN should assess the child's blood glucose levels and provide appropriate treatment.
3. A 10-year-old child with bleeding lacerations on both knees after falling on the playground. While bleeding lacerations require attention, they are not immediately life-threatening or likely to cause severe complications. However, the PN should still address this child's injuries promptly and provide appropriate wound care.
4. A 5-year-old child is crying uncontrollably because of an incontinent bowel episode. While the child's distress is significant, it does not indicate an immediate life-threatening condition or urgent medical need. The PN should provide comfort, and reassurance, and assist with appropriate hygiene measures for the child.

Prioritizing care in this order ensures that the most urgent and potentially life-threatening conditions are addressed first, followed by those requiring immediate attention but with a lower risk of complications. Finally, the PN can attend to the client with a condition that, while distressing, is not immediately life-threatening or urgent.