Mental Health Nursing
673.
28-year-old women is accompanied by her mother to the ward. She is admitted for her affective disorders with anger recent events and stammering spells. She has panic followed by apathy and listlessness. How should the nurse manage the patient?
الشرح
Core Concept: Patients with affective disorders who are experiencing panic, anger, or stammering spells are highly vulnerable to environmental stimuli and interpersonal conflict. A calm, low-stimulus environment helps de-escalate the autonomic nervous system arousal. Avoiding arguments prevents triggering further defensive or aggressive behaviors, promoting psychological safety.
Clinical Presentation:
- Affective disorder/Panic: Agitation, anger, stammering, panic attacks followed by apathy, listlessness, and exhaustion.
Diagnosis:
- First-line diagnostic plan: Comprehensive psychiatric assessment, mental status examination, and risk assessment (suicide/homicide).
- Gold standard test: Structured clinical interview for DSM-5 disorders.
Management:
- Acute management: Provide a quiet, safe environment. Use a calm, non-threatening tone. Avoid arguing or challenging delusions/distorted thoughts during the acute panic phase.
- Gold standard long-term/definitive management: Psychotherapy (CBT, dialectical behavior therapy), psychopharmacology (SSRIs, mood stabilizers), and developing a personalized crisis plan.