Labs
This lab is commonly ordered to rule out thyroid disease that can mimic depression or anxiety.
What is TSH (Thyroid-Stimulating Hormone)?
This medication requires routine monitoring of liver function tests and platelet counts.
What is valproic acid (Depakote)?
This is the first intervention a staff member should use when a patient becomes verbally agitated.
What is verbal de-escalation?
While a patient is in restraints, the nurse should continuously assess this to prevent injury.
What is circulation, range of motion, skin integrity, and respiratory status?
This level of observation requires staff to remain within arms length of the patient at all times.
What is 1:1?
This urine test helps determine whether substances are contributing to a patient’s psychiatric symptoms.
What is a Urine Drug Screen (UDS)?
This life-threatening reaction includes fever, muscle rigidity, autonomic instability, and elevated CK.
What is Neuroleptic Malignant Syndrome (NMS)?
This communication technique involves repeating the patient’s feelings to show understanding without agreeing with their behavior.
What is reflective listening?
These are the two most important reasons to discontinue restraints.
What are the patient is calm and no longer an imminent danger to self or others?
A patient with active suicidal intent and a plan is most likely to require this level of observation.
What is a 1:1 suicide watch?
This medication requires routine monitoring of blood levels because it has a narrow therapeutic index.
What is Lithium?
This PRN medication is commonly given for acute agitation and anxiety
What is lorazepam?
A patient is pacing, clenching their fists, and yelling. Before the behavior escalates further, the staff should recognize these as what?
What are early warning signs of aggression?
This type of restraint involves holding a patient without devices and should only be used briefly to gain control.
What is a physical hold (manual restraint)?
True or False: Patients on 1:1 observation may be left alone while using the bathroom.
What is false?
This white blood cell measurement must be monitored regularly in patients taking clozapine due to the risk of agranulocytosis.
What is the Absolute Neutrophil Count (ANC)?
A patient taking this mood stabilizer reports vomiting, diarrhea, tremors, and confusion. The nurse’s priority is to suspect toxicity and hold the medication.
What is lithium?
Physical restraints should only be used after these interventions have been attempted or if there is an immediate threat of harm.
What are the least restrictive interventions?
The duration of time an adult can be in restraints.
What is 4 hours?
This is the least restrictive level of observation used for patients who are stable and not at immediate risk.
What is routine observation (or Q15-minute checks?
This panel monitors blood sugar and cholesterol in patients taking second-generation antipsychotics because these medications increase the risk of metabolic syndrome.
What are the Hemoglobin A1c and Lipid Panel?
This atypical antipsychotic is associated with significant weight gain, hyperglycemia, and metabolic syndrome.
What is olanzapine (Zyprexa)?
After a behavioral emergency, staff should participate in this process to review the event and improve future care.
What is a debriefing?
What intervention should always continue while a patient is restrained?
What is therapeutic communication and ongoing attempts to help the patient regain control?
What is the primary purpose of increased observation?
What is to maintain patient safety?