A voluntarily hospitalized patient tells the nurse, Get me the ...

[tfester]

A voluntarily hospitalized patient tells the nurse, Get me the forms for discharge against medical advice so I can leave now. What is the nurse's best initial response?
 
  a. I can't give you those forms without your health care provider's knowledge.
  b. I will get them for you, but let's talk about your decision to leave treatment.
  c. Since you signed your consent for treatment, you may leave if you desire.
  d. I'll get the forms for you right now and bring them to your room.

Question 2

A nurse at the mental health center prepares to administer a scheduled injection of haloperidol decanoate (Haldol depot injection) to a patient with schizophrenia.
 
  As the nurse swabs the site, the patient shouts, Stop, stop I don't want to take that medicine anymore. I hate the side effects. Select the nurse's best initial action.
 
  a. Stop the medication administration procedure and say to the patient, Tell me more about the side effects you've been having.
  b. Say to the patient, Since I've already drawn the medication in the syringe, I'm required to give it, but let's talk to the doctor about skipping next month's dose.
  c. Proceed with the injection but explain to the patient that other medications are available that may help reduce the unpleasant side effects.
  d. Notify other staff members to report to the room for a show of force and proceed with the injection, using restraint if necessary.

[epscape]

Answer to Question 1

ANS: B
A patient who has been voluntarily admitted as a psychiatric inpatient has the right to demand and obtain release in most states. However, as a patient advocate, the nurse is responsible for weighing factors related to the patient's wishes and best interests. By asking for information, the nurse may be able to help the patient reconsider the decision. The statement that discharge forms cannot be given without the health care provider's knowledge is not true. Facilitating discharge without consent is not in the patient's best interest before exploring the reason for the request.

Answer to Question 2

ANS: A
Patients with mental illness retain their civil rights unless clear, cogent, and convincing evidence of dangerousness exists. The patient in this situation presents no evidence of being dangerous. The nurse, an as advocate and educator, should seek more information about the patient's decision and should not force the medication.

[tfester]

Excellent

[Zebsrer]

TYSM