A gravely disabled psychiatric patient has a guardian. What is ...

[olgavictoria]

A gravely disabled psychiatric patient has a guardian. What is the essential implication for nursing care?
 
  a. The patient can override the guardian's judgment at any time.
  b. Guardianship is a legal matter that does not affect clinical care.
  c. The guardian's rights apply only to a patient's financial interests.
  d. The guardian participates in treatment planning on behalf of the patient.

Question 2

Risk assessment for a patient shows these findings
 
  schizophrenia but not acutely psychotic at the moment; not a danger to self or others; lives in parents' home. Which decision regarding placement on the continuum of care is appropriate?
  a. Hospitalize the patient.
  b. Discharge the patient from the system.
  c. Refer the patient to outpatient services.
  d. Refer the patient to self-help resources in the community.

[coreycathey]

Answer to Question 1

D
Guardians make decisions on behalf of the patient and represent the patient in treatment planning meetings. Guardianship affects clinical care, as previously mentioned. The guardian has the right to refuse treatment for the patient. The patient cannot override the guardian's judgment, because the patient is considered incompetent.

Answer to Question 2

C
Referral should be made to the least restrictive, most effective, and most cost-conscious source of services. Because the patient is not a danger to self or others, hospitalization is not needed. However, follow-up as an outpatient would be more appropriate than referral to a self-help group, in which structure might be lacking, or discharge from the system.