A patient in a long-term care facility is irritable and labile and has been being rude to staff throughout the shift, using obscenities and foul language. A nurse administers 10 mg haloperidol (Haldol)  IM for severe agitation. You know this is an example of which of the following?

Chemical restraints


•This is an example is a "chemical restraint," which is defined as any drug used for discipline or convenience and not required to treat medical symptoms. Chemical restraint involves use of a drug to restrict a patient’s movement or behavior, where the drug or dosage used isn’t an approved standard of treatment for the patient’s condition. Many healthcare facilities prohibit the use of medications for chemical restraint.

•Though the patient is irritable and rude, this does not meet the criteria for severe agitation. The use of Haldol 10 mg IV, prescribed for severe agitation, is inappropriate.  Improper restraint use can lead to serious sanctions by the state health department, The Joint Commission (TJC), or both.

•If there was a lower dose prescribed to calm the patient only, it may be appropriate. Haldol 10 mg is a high dose that would cause excessive sedation and is to be used in emergencies when a client is putting themselves or others at risk of physical harm. 

Incorrect options:

•This is not an example of an appropriate PRN order for sedation, and there was no indication that the patient was putting anyone at risk for physical harm.

•This is not appropriate "discipline," and drugs are never to be used in this manner.

•This is not a part of the treatment plan because the order indicates that the Haldol is for severe agitation, not to calm a patient who is being rude.

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