A nurse is completing a peer evaluation. Which of the following actions will ensure the peer evaluation is impartial?

A) Administer PRN haloperidol IM to the client:

Administering haloperidol is not the first-line intervention for managing behavioral disturbances in clients with dementia, especially in response to acute agitation. While antipsychotic medications like haloperidol may be prescribed in some cases, they should be used judiciously due to the risk of adverse effects, particularly in elderly clients. Additionally, administering medication should not be the first action taken without attempting non-pharmacological interventions.

B) Engage the client in a repetitive activity as a distraction:

This is the most appropriate initial intervention when dealing with an agitated client with dementia. Engaging the client in a repetitive, calming activity can help redirect their focus and reduce agitation. Simple, familiar tasks or activities tailored to the client's preferences can be effective in providing comfort and reducing distress.

C) Apply wrist restraints to the client:

Using physical restraints should be avoided unless absolutely necessary for the safety of the client or others. Restraints can cause physical and psychological harm, increase agitation, and compromise the client's dignity and autonomy. Therefore, restraint use should be a last resort and implemented only after other interventions have been attempted and deemed ineffective or when there is an imminent risk of harm.

D) Place the client in a seclusion room:

Seclusion should not be used as an initial intervention for managing agitation in clients with dementia. Seclusion can exacerbate distress and increase feelings of isolation and fear, which may escalate agitation further. It should only be considered as a last resort for managing severe agitation or aggression when all other interventions have failed and there is a risk of harm to the client or others.

A) The surgeon should delay surgery until he can obtain informed consent from a parent:

This option is not feasible in emergencies where immediate surgical intervention is required to save the client's life or prevent further harm. Delaying surgery could jeopardize the client's health and violate the principle of beneficence, which prioritizes the client's well-being.

B) The client's pediatrician can obtain implied consent:

While pediatricians often play a role in providing medical care to minors, implied consent typically pertains to emergency situations where immediate intervention is necessary, and obtaining consent from a parent or legal guardian is not possible. In this scenario, the surgeon, rather than the pediatrician, would be responsible for obtaining consent.

C) The surgeon can proceed with the surgery by invoking implied consent:

In emergency situations where immediate surgical intervention is required to prevent harm or save a client's life, healthcare providers may proceed with treatment under the doctrine of implied consent. Implied consent assumes that a reasonable person would consent to necessary medical treatment if they were able to do so. However, the specific legal requirements for invoking implied consent may vary depending on jurisdiction and institutional policies.

D) The surgeon can obtain informed consent from the client's adult cousin:

While obtaining consent from a close family member may be necessary in certain situations, such as when a parent is unavailable, it may not be legally sufficient in emergency situations where immediate action is required. Additionally, the legal authority to provide consent may vary depending on the jurisdiction and the client's age. In this scenario, relying on informed consent from the client's adult cousin could delay necessary surgical intervention and may not be appropriate without further legal clarification.