Nurs 6660-W5 Discussion 4.docx explained

rgencies in Children Versus Adults A psychiatric emergency is a disturbance of mood, behavior, or thought which may lead to harm to the individual or others if untreated (Sadock, Sadock, & Ruiz, 2014). In both pediatric and adult psychiatric emergencies, the clinician must ensure the safety of everyone involved (Chun, Katz, Duffy, 2013). A complete assessment should be performed. Goals of the psychiatric emergency assessment are to determine whether client poses a risk of harm to self or others, confirm the presence of a psychiatric disorder, determine factors that may have lead to the issue, and determine how the illness has impaired the client’s normal level of functioning, identify the client’s strengths, target the problems for treatment, and determine the level of care the client requires (Carandang, Gray, Marval-Ospino, & MacPhee, 2012). One of the most common pediatric psychiatric emergencies is suicidal behaviors (Chun et al., 2013). Description of Adult Psychiatric Emergency Case Working and doing my practicum in an acute psychiatric hospital, I have cared for many adults with psychiatric emergencies. In my last rotation, a 30-year-old Caucasian female with suicidal ideations with a plan to overdose presented to the facility for evaluation. She reported feeling overwhelmed due to (a) a recent separation from her husband, (b) becoming a single mother, and (c) struggling financially. The client was wheelchair bound due to a motor vehicle accident and felt she was a burden to her family. She was assessed by a therapist, and the psychiatrist on call admitted the client with a diagnosis of major depressive disorder. The client was placed on one-to-one observation, a level of observation that requires the assigned staff member to be within three feet of the client at all times. Laboratory testing included a complete blood count, comprehensive metabolic panel, thyroid stimulating hormone level, magnesium level, phosphorous level, urine drug screen, urine pregnancy test, and pharmacogenetic testing for psychiatric medications. After less than an hour on the adult unit, the client stated she wanted to go home and filled out paperwork requesting release. The client was placed on a 72-hour hold. An initial psychiatric evaluation was performed by the psychiatric mental health nurse practitioner later in the day, and the client was started on an antidepressant. The client’s level of observation was downgraded to line of sight after 24 hours then to every 15-minute checks the following day. She received daily group psychotherapy, weekly individual psychotherapy, and evaluated by either a psychiatric mental health nurse practitio