A patient diagnosed with bipolar disorder is admitted involuntarily during a manic phase. Lithium 300 mg PO t.i.d. is prescribed. The patient refuses the morning dose. What are the nurse's best actions? Select all that apply
a. Get the prescription changed to an elixir, and administer it in juice.
b. Assemble adequate help to force the patient to take the medication.
c. Educate the patient about the importance of lithium in stabilizing the mood.
d. Allow the patient to refuse the medication, and document the patient's comments.
e. Inform the patient that unit privileges are contingent on taking prescribed medications.
C, D
Patients have the right to refuse consent to treatment, including medication administration. The courts have ruled that neither voluntary nor involuntary patients can be forced to take psychotropic medication. Hiding the medication in food or fluids is not ethical. Assembling a show of force implies that forcible administration will occur. Making privileges contingent on medication ingestion is coercion.
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