AIIMS Delhi NO- 2019
Mental Health Nursing
Hard
Priority action of patient agitation management?
Appeared in: AIIMS Delhi NO- 2019
Explanation
- The priority in managing agitation is to ensure the safety of the patient, staff, and others.
- The first and least restrictive step in de-escalation is to modify the environment to reduce triggers, such as excessive noise, light, or people.
- Moving the patient to a quiet, safe, and non-stimulating area helps them calm down and regain a sense of control, preventing further escalation.
- This proactive approach addresses the root cause of the agitation (overstimulation) and establishes a foundation for therapeutic communication.
Why Other Options Were Wrong
- Option A: Arguing or trying to reason with an agitated patient is ineffective and often escalates the situation. Their ability to process logic is impaired due to emotional dysregulation.
- Option B: Leaving an agitated patient alone is a form of neglect and is unsafe. The patient requires observation and support to prevent self-harm or harm to others.
- Option D: This option is incorrect because a valid and appropriate priority action is provided in Option C.
Related Visual
Clinical Relevance
- Nursing practice connection: Safe nursing care depends on performing Management of Patient Agitation and De-escalation Techniques in the correct sequence, documenting the action clearly, and monitoring for the expected response.
- Nurses must be proficient in de-escalation to maintain a safe therapeutic milieu in all clinical areas, including emergency departments, psychiatric units, and general medical floors.
- Prompt and effective environmental management can prevent the need for more restrictive and potentially traumatic interventions like chemical or physical restraints.
- What if? If the patient's agitation escalates to physical violence despite environmental changes, the priority immediately shifts to ensuring the safety of everyone. This involves calling for a rapid response or security team, removing other patients from the area, and preparing for a team-based restraint as a last resort, following facility protocol.
How to Approach the Question
- First, identify the question as a 'priority action' question, which requires you to select the most important and immediate nursing intervention.
- Recall the fundamental principles of psychiatric nursing: safety first, followed by the use of the least restrictive intervention.
- Evaluate each option based on these principles. Does the action ensure safety? Is it the least restrictive choice?
- Eliminate options that are clearly non-therapeutic or dangerous. Arguing (confrontational) and leaving the patient alone (neglectful) are unsafe.
- Select the option that proactively addresses the patient's distress while maintaining safety. Decreasing stimuli and providing a safe space is a foundational de-escalation technique that achieves both goals.
Concept Tested & Keywords
- Concept Tested: Management of Patient Agitation and De-escalation Techniques
- Stem keywords: patient agitation, management
- Lead-in keywords: Priority action
- Negative lead-in flag: false
Question ID
Q9bwdidTceEkIh4-VaEd_g
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 8843-8845, 8836-8838, 8842-8844
Practise the full AIIMS Delhi NO- 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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