A patient with a history of anger and impulsivity was ...

[michelleunicorn]

A patient with a history of anger and impulsivity was hospitalized after an accident resulting in injuries. When in pain, the patient loudly scolded nursing staff for not knowing enough to give me pain medicine when I need it.
 
  Which nursing intervention would best address this problem?
 
  a. Teach the patient to use coping strategies such as deep breathing and progressive relaxation to reduce the pain.
  b. Talk with the health care provider about changing the pain medication from PRN to patient-controlled analgesia.
  c. Tell the patient that verbal assaults on nurses will not shorten the wait for analgesic medication.
  d. Talk with the patient about the risks of dependency associated with overuse of analgesic medication.

Question 2

A patient with multi-infarct dementia lashes out and kicks at people who walk past in the hall of a skilled nursing facility. Intervention by the nurse should begin by:
 
  a. gently touching the patient's arm.
  b. asking the patient, What do you need?
  c. saying to the patient, This is a safe place.
  d. directing the patient to cease the behavior.

[amcvicar]

Answer to Question 1

ANS: B
Use of patient-controlled analgesia will help the patient manage the pain. This intervention will help reduce the patient's anxiety and anger. Dependency is not an important concern related to acute pain.

Answer to Question 2

ANS: C
Striking out usually signals fear or that the patient perceives the environment to be out of control. Getting the patient's attention is fundamental to intervention. The nurse should make eye contact and assure the patient of safety. Once the nurse has the patient's attention, gently touching the patient, asking what he or she needs, or directing the patient to discontinue the behavior may be appropriate.

[michelleunicorn]

Excellent

[Joy Chen]

TYSM