A patient with a history of anger and impulsivity is hospitalized ...

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A patient with a history of anger and impulsivity is hospitalized after an accident resulting in injuries. When in pain, the patient loudly scolds the nursing staff for not knowing enough to give me pain medicine when I need it.
 
  Which nursing intervention would best address this problem?
 
  a. Tell the patient to notify nursing staff 30 minutes before the pain returns so the medication can be prepared.
  b. Urge the health care provider to change the prescription for pain medication from as needed to a regular schedule.
  c. Tell the patient that verbal assaults on nurses will not shorten the wait for pain medication.
  d. Have the clinical nurse leader request a psychiatric consultation.

Question 2

A patient with severe injuries is irritable, angry, and belittles the nurses. As a nurse changes a dressing, the patient screams, Don't touch me You are so stupid. You will make it worse
 
  Which intervention uses a cognitive technique to help the patient?
 
  a. Wordlessly discontinue the dressing change, and then leave the room.
  b. Stop the dressing change, saying, Perhaps you would like to change your own dressing.
  c. Continue the dressing change, saying, Do you know this dressing change is needed so your wound will not get infected?
  d. Continue the dressing change, saying, Unfortunately, you have no choice in this because your doctor ordered this dressing change.

[ebenov]

Answer to Question 1

ANS: B
Scheduling the medication at specific intervals will help the patient anticipate when the medication can be given. Receiving the medication promptly on schedule, rather than expecting nurses to anticipate the pain level, should reduce anxiety and anger. The patient cannot predict the onset of pain before it occurs.

Answer to Question 2

ANS: C
Anger is cognitively driven. The correct answer helps the patient test his cognitions and may help lower his anger. The incorrect options will escalate the patient's anger by belittling or escalating the patient's sense of powerlessness.

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Thank you

[ebenov]

Happy to help you