The nurse is helping a client walk in the hallway when the client suddenly reaches for the handrail and states, "I feel so weak. I think I am going to pass out." Which of the following initial actions by the nurse is appropriate?
A) Firmly grasp the client's gait belt.
B) Support the client's body against yours and gently slide the client onto the floor.
C) Ask the client to lean against the wall while you obtain a wheelchair.
D) Apply oxygen and wait several minutes for the weakness to pass.
E) Ask the patient, "When was the last time you ate?"

Question

Quizplus · Accepted Answer

Supporting the client's body against yours and gently sliding the client onto the floor is the appropriate action because it ensures that the client does not fall and sustain injury. It also allows the nurse to further assess the client's condition while awaiting further assistance. Option A, grasping the gait belt, may not provide enough support to prevent a fall. Option C, asking the client to lean against the wall, is not safe in case the client loses consciousness. Option D, applying oxygen and waiting, assumes that the client's condition is related to hypoxia, without further assessment. Option E, asking about the last meal, is important but it does not address the immediate risk of falling.

The Nurse Is Helping a Client Walk in the Hallway