A patient with a score of +4 on the RASS is considered to be?

A score of +4 on the Richmond Agitation-Sedation Scale (RASS) indicates that a patient is exhibiting combative behavior. The RASS is a tool used to assess a patient's level of alertness and agitation. In this scale, negative scores indicate sedation, while positive scores indicate varying levels of agitation.

A +4 score specifically denotes that the patient is extremely agitated, exhibiting behaviors such as pulling at tubes, thrashing around, or behaving in a manner that is potentially harmful to themselves or others. This level of agitation is categorized as combative, requiring immediate intervention to ensure the safety of the patient and those around them. Other interpretations of the RASS scale categorize lower positive scores into levels such as alert but confused or calm and cooperative, but these do not apply to a +4 score.