Question

You are called by the medicine team to do a psychiatric consultation on a 90-year-old female with sepsis who is agitated, confused, and disoriented and is pulling out her lines. The medical team tells you that her mentation has been waxing and waning throughout the day. Your first consideration in approaching the case is:

A. Determining capacity to refuse treatment
B. Speaking to the patient's family
C. Examining the patient's medication regimen
D. Developing a therapeutic relationship with the patient
E. Protecting the patient from unintended harm

Answer 1

The first consideration in a psychiatric consultation for an agitated elderly patient with sepsis should be to protect the patient from unintended harm. Therefore, the correct option is E.

Step-by-step explanation:

You are called by the medicine team to do a psychiatric consultation on a 90-year-old female with sepsis who is agitated, confused, and disoriented, and is pulling out her lines. The first consideration in approaching this case should be E. Protecting the patient from unintended harm. This is paramount as the patient is not in a state to protect herself and may unintentionally cause herself injury. Once the patient is safe, further assessments regarding her medication regimen, capacity to refuse treatment, family consultation, and developing a therapeutic relationship can follow.