A patient who has been pacing rapidly for the past hour cannot immediately be located on the unit. When he is found, he is in his closet, rocking back and forth rapidly and talking rapidly to himself
When staff approach, he only seems to notice them momentarily, then leaves his room and begins running up and down the hallway. Which of the following interventions should be attempted at this point? a. "I want you to breathe deeply as I do, in slowly, now hold it, now breathe out.".
b. "I have some medicine that will calm you; would you like it by pill or in a shot?"
c. In a calm but direct voice say: "Stop running. I will stay with you. Walk with me.".
d. Gather a show of force and say: "You need to come with us now to seclusion.".
C
The patient's behavior is consistent with a panic level of anxiety. Calm, brief, directive verbal instructions can help such patients gain control of overwhelming feelings and impulses. Patients experiencing panic-level anxiety are unable to focus and integrate new information into memory, making teaching likely to be ineffective until their anxiety is reduced. Antianxiety medications and seclusion would be a back-up intervention if verbal interventions fail. However, although providing an opportunity for the patient to participate in decisions about his care is usually desirable, asking the patient to choose the route of medication to be used at a time when understanding and decision making are impaired is not therapeutic. Seclusion could be interpreted as punishment or perceived as a threat, and in turn heighten his fear and panic; it should be reserved for situations when all other options have failed or no other intervention can provide acute safety needs.
You might also like to view...
During an assessment, the nurse learns that an older patient does not feel refreshed in the morning after sleeping and reports that family members complain about the loud snoring at night
Which assessment finding supports sleep apnea as a potential problem for this patient? 1. Short stature 2. Hypertension 3. Female gender 4. Thin body build
A pilot study reveals a wide variation in measurement values among subjects with an overall mean value that is higher than among the general population. By increasing the sample size in a subsequent study, the researcher expects to
a. decrease the variation of scores among subjects. b. increase the variation of scores among subjects. c. decrease the mean value of scores among subjects. d. increase the mean value of scores among subjects.
To determine the position of the decimal point when multiplying decimals, you should
A. count the total number of places to the right of the decimal point in both numbers. B. count the total number of places to the left of the decimal point in both numbers. C. count the places to the right of the decimal point in the number you are multiplying by. D. count the places to the left of the decimal point in the number you are multiplying by.
Injuries among older adults resulting from falls in the home are due to intrinsic and extrinsic factors. Which one of the following is an example of an extrinsic factor?
a. Illness b. Drug therapy c. Environmental obstacles d. Alcohol use