Week 8: Psychiatric Emergencies
A psychiatric emergency is a situation that if left untreated is likely to cause harm to oneself or others. These acute disturbances of behavior may manifest as suicidal ideation or attempts, violence, agitation, drug overdose, delirium, psychosis, mania, neuroleptic malignant syndrome, or serotonin syndrome. When psychiatric emergencies arise, they can present many challenges to the PMHNP. While many approaches to emergencies are similar when dealing with children and adolescents versus adults, significant differences also exist. This is particularly true with coordination of care, availability of resources, and legal implications of the psychiatric emergency. A psychiatric emergency is a life-threatening situation that can result in serious harm to others. It can be triggered by a variety of behavioral disturbances, such as psychosis or acute psychosis.
This week, you examine psychiatric emergencies and explain the ethical and legal issues surrounding these events. You will also review evidence-based suicide and violence risk assessments that you may use to screen patients.
Learning Objectives
Students will:
Explain salient ethical and legal issues relevant to psychiatric emergencies in psychiatric-mental health practice
Select evidence-based risk assessments for psychiatric emergencies
Learning Resources
Required Readings (click to expand/reduce)
Medication Review
Review the FDA-approved use of the following medicines related to treating psychiatric emergencies:
Aggression Behavioral problems Cataplexy syndrome
clozapine
propranolol
zuclopenthixol aripiprazole
asenapine
chlorpromazine
haloperidol
iloperidone
lurasidone
olanzapine
paliperidone
quetiapine
risperidone
ziprasidone clomipramine
imipramine
sodium oxybate
Catatonia Extrapyramidal side effects Mania
alprazolam
chlordiazepoxide
clonazepam
clorazepate
diazepam
estazolam
flunitrazepam
flurazepam
loflazepate
lorazepam
midazolam
oxazepam
quazepam
temazepam
triazolam benztropine
diphenhydramine
trihexyphenidyl alprazolam (adjunct)
aripiprazole
asenapine
carbamazepine
chlorpromazine
clonazepam (adjunct)
iloperidone
lamotrigine
levetiracetam
lithium
lorazepam (adjunct)
lurasidone
olanzapine
quetiapine
risperidone
sertindole
valproate (divalproex)
ziprasidone
zotepine
Assignment: Legal and Ethical Issues Related to Psychiatric Emergencies
Photo Credit: Getty Images
The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations. In their role, PMHNPs can ensure a smooth transition from emergency mental health care to follow-up care, and also bridge the physical–mental health divide in healthcare.
In this week’s Assignment, you explore legal and ethical issues surrounding psychiatric emergencies, and identify evidence-based suicide and violence risk assessments.
To Prepare
Review this week’s Learning Resources and consider the insights they provide about psychiatric emergencies and the ethical and legal issues surrounding these events.
The Assignment
In 2–3 pages, address the following:
Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released. Explain the laws regarding involuntary psychiatric holds for children and adults.
Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
Explain the difference between capacity and competency in mental health contexts.
Select one of the following topics, and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source.
Identify one evidence-based suicide risk assessment that you could use to screen patients.
Identify one evidence-based violence risk assessment that you could use to screen patients.
By Day 7 of Week 8
Submit your Assignment. Attach copies of or links to the suicide and violence risk assessments you selected.Essentials of pathophysiology
Title: Immune System Disorders
Number of sources: 2
Paper instructions:
Instructions: Content: Identify a person you know who has an immune system disorder or cancer.
Interview the affected person and write a 3 thru 5 pages summary of the interview, including:
.Identify the pathophysiology of the immune system disorder
.Discuss the treatment for the immune system disorder
.Summarize the findings of the interview
.Use at least one scholarly source to support your findings or identify therapies that may be new or different from what the affected person may be using.
Questions you may want to use to guide your interview:
1.How would you describe your immune system disorder? 2.How long have you had this disorder? 3.How has this disorder changed your life (home and work)? 4.Are you able to carry out daily activities independently? 5.What treatments are you using to manage this disorder? 6.What side effects have you experienced with the treatments? Your response will help us to better understand your condition.
The answer to this question will help us to better understand how this disorder affected you. It will also help us to develop effective treatment plans.
How has this disorder affected your body?
7.How has this disorder changed your body? 8.How has this disorder impacted you emotionally? 9.Have alternative therapies, such as Eastern medicine (acupuncture, herbal treatment, yoga) been tried or recommended?
cite your source in-text and on a references page using APA format
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