Author Question: A patient who is known to be angry and impulsive is hospitalized after an automobile accident in ... (Read 38 times)

genevieve1028 · **on:** Jul 19, 2018

A patient who is known to be angry and impulsive is hospitalized after an automobile accident in which he sustained severe orthopedic injuries.

When in pain, he loudly berates nursing staff, saying, You jerks don't even know enough to give a patient pain medicine when he needs it.. The patient's nursing diagnosis is Ineffective coping. Which nursing intervention would best address this situation? a. If you could tell us about wanting the medicine before your pain becomes this bad, it would help..
b. I can see you are frustrated, but rudeness toward nurses will not help you get your medication any sooner..
c. I'm concerned that there may be something we overlooked; I'm going to ask a psychiatric specialist to evaluate you..
d. Pain can make anyone miserable; I will ask your doctor to change the order so you get medicine regularly without having to ask..

Question 2

The client is a 30-year-old male with chronic mental problems. Until recently, he was able to stay in his home with care from his mother and regular visits from the community mental health nurse. Last week, his mother had a stroke.

Because she now requires long-term care, the client will be admitted to the inpatient psychiatric facility. The reason for the client's admission is that 1. he is violent when left alone.
2. no one knows what to do with him.
3. he cannot care for himself independently.
4. he is a threat to others because of his odd behavior.

lkoler · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

D
Acknowledging and normalizing the patient's pain, along with scheduling the medication at specific intervals, will help the patient anticipate when the medication can be given and help correct his perception of nurses as uncaring or unskilled. Receiving the medication promptly on schedule, rather than expecting nurses to intuitively know his pain level, should minimize his discomfort and reduce his acting out of anxiety and anger. Suggesting that the patient might behave differently also implies that he is at fault; telling a person who already believes staff are incompetent that he is at fault is likely to evoke more anger, not less. Confronting the patient with his rudeness may meet the nurse's need to confront the patient, but it does not address the patient's pain and is likely to increase the adversarial nature of the current patient-staff relationship, when the opposite is desired instead. Unless there is specific indication of a mental illness, which is not the case here, a psychiatric consult is not indicated, and the desire to blame a mental illness suggests that the nurse is angry and retaliating. Suggesting to the patient that he is mentally ill is also likely to intensify his anger and make the nurse-patient relationship even less therapeutic.

Answer to Question 2

3
Admission to a psychiatric inpatient facility occurs when people in the environment are not able or willing to support the mentally troubled person.