Question

A manic patient angrily demands that the nurse "leave me alone and

stop being so annoying" after being reminded of unit rules. After the
patient fails to respond to distraction and other de-escalation
techniques and refuses PRN medication, which action would the
nurse take to best assure safety in the mileu?
Inform the patient they will be placed in seclusion if they don't go to their
room.
Contact the health care provider for a restraints prescription.
Require that the other patients to go to their rooms.
Remind the patient of the limits and consequences discussed at the time
of admission.

Answer 1

In this situation, the nurse should remind the patient of the limits and consequences discussed at the time of admission to promote a safe milieu.

Step-by-step explanation:

In this situation, the nurse should remind the patient of the limits and consequences discussed at the time of admission. By reminding the patient about the unit rules and consequences, the nurse is reaffirming expectations and promoting a safe milieu. This can help the patient understand the importance of following rules and potentially de-escalate the situation.

Informing the patient about potential seclusion can be seen as a threat and may further agitate them. Contacting the healthcare provider for a restraints prescription should only be considered as a last resort if the patient becomes physically aggressive and poses an immediate threat to themselves or others. Requiring other patients to go to their rooms may disrupt the therapeutic environment and potentially escalate the situation.

Learn more about managing manic patients in a healthcare setting