Patient Evaluation
Once the safety of the patient and those around him is assured, a thorough evaluation is needed to identify contributing factors and to prevent further episodes. Medical, psychiatric and medication histories are core to an effective evaluation. Physicians, nurses, and pharmacists should participate using their particular expertise. Contributing factors may become clear after reviewing the patient’s psychiatric history, especially if noncompliance, substance abuse, or psychosocial stressors coexist. A mental status exam identifying underlying symptoms, such as hallucinations or delusional thinking, will further guide treatment. Patients who develop agitation two to three weeks after starting antipsychotic treatment should be evaluated for akathisia as a potential underlying cause. When the cause is unknown, physical examinations and laboratory tests that identify common causes of aggression due to a general medical condition are undertaken (Table 3). The need for a specific test is based on the patient’s presentation, physical findings, and medical history. The social context and environmental precipitants surrounding the aggression are also important to explore. During the initial assessment of all patients, it is important to determine their specific risk for aggression, even if they are currently calm, as preventable measures may be taken to minimize risk.
|
Table 3. Common Tests to Identify Medical
Causes of Agitation and Aggression |
|
General examinations: Common Laboratory Tests Other tests |
This post has been viewed 20 times.
Related posts:
- Acute Agitation and Aggression in Psychiatric Illnesses. Part 11 Legal Considerations By today’s standards restraint and seclusion are to be used as safety measures, not as part of the treatment plan. According to the United States Health Care Financing Administration (HCFA), “A drug used as a restraint is a medication used to...
- Acute Agitation and Aggression in Psychiatric Illnesses. Part 3 Causes There are two ways to describe the causes of agitation and aggression: by the underlying disease state (see Table 1), or the exact pathophysiology that causes the aggression. The DSM-IV-TR has several diagnostic categories describing the relationship between a medical condition or...
- Acute Agitation and Aggression in Psychiatric Illnesses. Part 5. Treatment Treatment Goals The first goal is to ensure safety of the patient and those around him. Secondly, symptoms need to be reduced to such a degree that safety is no longer a problem and further medical and psychiatric assessments can be completed in...
- Acute Agitation and Aggression in Psychiatric Illnesses. Part 9. Treatment Atypical Antipsychotics vs. Typical Antipsychotics: Typical antipsychotics, particularly haloperidol, are still the most commonly used agents for treating agitation and aggression because of clinician comfort and experience with their use. Haloperidol is efficacious and can be given orally as a solution or tablet,...
- Acute Agitation and Aggression in Psychiatric Illnesses. Part 1 Agitation and aggression are common symptoms in inpatient psychiatric settings, geriatric medicine and emergency room care. For example, some 10% of patients admitted to psychiatric services with chronic psychiatric disorders exhibited violence toward others prior to admission. About half of patients with Alzheimer’s...
Hello, everybody, who is interested to be healthy. My name is Kelly. I learnt about depression by my own experience. Now I am ok. Here I want to share my thoughts and ideas how to treat depression symptoms.