Discussion: Treatment of Psychiatric Emergencies in Children And Adults

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.

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In this week’s Discussion, you compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients.

To Prepare:

• Review the Learning Resources concerning emergency psychiatric medicine.
• Consider a case where your adult client had a psychiatric emergency.

Post:

• Briefly describe the case you selected.
• Explain how you would treat the client differently if he or she were a child or adolescent.
• Explain any legal or ethical issues you would have to consider when working with a child or adolescent emergency case.

References to look at:

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 23, “Emergency Psychiatric Medicine” (pp. 785–790)
• Chapter 31, “Child Psychiatry” (pp. 1226–1253) Discussion: Treatment of Psychiatric Emergencies in Children And Adults
• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

• “Bipolar and Related Disorders”

Psychiatric Emergencies in Adults versus Children

A brief description of a case where an adult client had a psychiatric emergency

Jameson, a 50-year-old man checked into the hospital’s emergency department for psychiatric treatment. The client had previously been diagnosed with psychotic disorder. The client presented with alarms of general unsteadiness, dizziness, and delusions. The doctor assessed Jameson and ordered numerous laboratory tests. After examination, the doctor diagnosed Jameson with acute psychosis.

How I would treat the client differently if he were an adolescent or child

If the client were a child or an adult, I could have systematically and concisely assessed him to establish if the young individual had an acute mental disorder or a psychiatric mental problem which presented with an emergency. In order to distinguish medical mimics or medical illnesses from a mental disorder, a correct physical exam, mental status, history as well as clinically designated testing are utilized (Zun, 2016) Discussion: Treatment of Psychiatric Emergencies in Children And Adults.

According to Carandang et al (2015), evaluation of an adolescent is different from that of an older person. While the majority of adults seek psychiatric assessment on their own, it is rare for children to seek an assessment. Additionally, depending on development and age, majority of children are not capable of offering clinically essential and historical information. Therefore, I would place more emphasis on the significance of numerous informants, including parents, teachers, and caregivers. Sadock et al (2014) argue that the emergency department is usually the first contact with psychiatric health scheme and is being utilized as a protective net for diagnosis and management of mental disorders in youngsters.

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Ethical issues to consider when working with a child or adolescent emergency case

The key ethical issues when dealing with are respect for autonomy, and privacy of the client.  Carandang et al (2015) argue that adolescents and children cherish their independence and privacy and usually share information if they are sure that this information will remain confidential. Nurse practitioners must outline the circumstances in which sharing information with parents, including safety issues like homicidal and suicidal thoughts Discussion: Treatment of Psychiatric Emergencies in Children And Adults.

References

Carandang, C., Gray, C., Macphee, S., & Marval- Ospino. (2015). Child and adolescent psychiatric emergencies. In Rey, M (ed.).  IACAPAP Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions psychiatry.

Sadock, J., Sadock, A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/ clinical psychiatry. (11^th ed.). Philadelphia, PA: Wolters Kluwer.

Zun, L. (2016). Care of Psychiatric Patients: The Challenge to Emergency Physicians. Western Journal of Emergency Medicine, 17(2): 173-176 Discussion: Treatment of Psychiatric Emergencies in Children And Adults