Author Question: The manipulative patient approaches the nurse and says, I know it's too early to give me my pain ... (Read 12 times)

crazycityslicker · **on:** Jun 25, 2018

The manipulative patient approaches the nurse and says, I know it's too early to give me my pain medication, but you are the only one who seems to care. Could you give me my pain medi-cation now? Which response is best?

a. The charge nurse is very stringent about scheduled medications. She would be very angry with me if I gave you the medica-tion now.
b. I know how it is when you are in pain. I'll give you your medication early.
c. Your medication is due in 2 hours. I will be glad to give it to you on schedule.
d. It makes me feel good to know you are appreciative of our care. Here is your me-dication.

Question 2

The delusional patient has become agitated and angry. The patient reports that the cook put tacks in his cereal. He is pacing back and forth in the crowded dining room and cursing the cook. How should the nurse respond?

a. Keep distance from the patient and ask, Can we go to the dayroom and talk?
b. Touch the patient's arm and say, Calm down. I'm sure we can straighten this out.
c. Call experienced CNAs to restrain the pa-tient.
d. Stand calmly and say, This behavior is unacceptable. Sit down and eat, Carl.

Andromeda18 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

C
Setting clear limits is important when managing manipulative patients. Once limits are set, it is important to maintain them. Blaming the charge nurse provides incentive for further manipulative behaviors. The nurse telling the patient that they know what it is like when they are in pain is not accurate or therapeutic. Providing the medication early likely does not follow the prescribed plan.

Answer to Question 2

A
Allowing the angry patient space is important. Encourage the patient to find a quieter place. Ac-knowledge the anger and demonstrate willingness to help. The agitated patient should not be touched without permission. Restraints are a last resort and will increase the patient's anger and feelings of persecution.