An older inpatient becomes confused over two hours, cannot maintain attention, and alternates between drowsiness and agitation. Which finding should the nurse report first?
Correct answer: C. The patient has a sudden change in attention and awareness
- A. The patient refuses to attend group therapy
- B. The patient reports a dislike of the hospital food
- C. The patient has a sudden change in attention and awareness
- D. The patient asks repeatedly when discharge will occur
Explanation
A sudden fluctuating disturbance in attention and awareness suggests delirium, which may result from infection, hypoxia, medication effects, or another medical emergency. This differs from the gradual, stable pattern often seen in chronic psychiatric illness and requires urgent medical assessment.
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About Psychiatric Emergencies
Psychiatric emergencies include suicidal behavior, homicide risk, severe agitation, panic, acute psychosis, delirium, overdose, and withdrawal states. Students examine rapid risk assessment, crisis intervention, de-escalation, environmental safety, emergency medication, observation levels, and the immediate priorities that differ from routine psychiatric nursing care.
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