Discussion 3
A PMHNP resource hub for ER psychosis assessments, featuring case dialogues, schizophrenia evaluation tools, de‑escalation strategies, involuntary hold protocols, and acute medication management guidance.
Daniel Miller
Contributor
5.0
60
2 months ago
Preview (1 of 3)
Sign in to access the full document!
Discussion 3.1: Assessing a Person in Psychosis
** Margaret has presented to the ER due to fear that she is being poisoned.
A full medical work-up has been completed by ER physician and there is no
evidence of poisoning. The ER doctor consults me to come and complete a
psychiatric assessment as it appears this patient has a pre-existing
diagnosis of schizophrenia in her chart.
ER physician reports that Margaret lives in a supported community with
staff on-site due to her history with noncompliance and difficulty managing
her schizophrenia. It is also reported that Margaret stopped taking her
antipsychotic medications 2 weeks ago when she initially had concerns of
poisoning and her paranoia has continued to escalate. She is currently on
1:1 supervision in the ER as an elopement risk and a danger to herself and
others.
**MEETING WITH MARGARET**
Hi Margaret, my name is Ashley. I am a psychiatric mental health nurse
practitioner, and I have been asked to come meet with you. Can you tell me
what is going on and what brings you to the emergency room today?
Margaret: I really don't know what is going on, the staff where I stay just
dropped me off here and left me.
PMHNP: Do you know what would have caused them to feel the need to
bring you in?
Margaret: I know they are the ones trying to poison me, I am sure this is
just their next step to getting rid of me.
** Margaret has presented to the ER due to fear that she is being poisoned.
A full medical work-up has been completed by ER physician and there is no
evidence of poisoning. The ER doctor consults me to come and complete a
psychiatric assessment as it appears this patient has a pre-existing
diagnosis of schizophrenia in her chart.
ER physician reports that Margaret lives in a supported community with
staff on-site due to her history with noncompliance and difficulty managing
her schizophrenia. It is also reported that Margaret stopped taking her
antipsychotic medications 2 weeks ago when she initially had concerns of
poisoning and her paranoia has continued to escalate. She is currently on
1:1 supervision in the ER as an elopement risk and a danger to herself and
others.
**MEETING WITH MARGARET**
Hi Margaret, my name is Ashley. I am a psychiatric mental health nurse
practitioner, and I have been asked to come meet with you. Can you tell me
what is going on and what brings you to the emergency room today?
Margaret: I really don't know what is going on, the staff where I stay just
dropped me off here and left me.
PMHNP: Do you know what would have caused them to feel the need to
bring you in?
Margaret: I know they are the ones trying to poison me, I am sure this is
just their next step to getting rid of me.
Preview Mode
Sign in to access the full document!
100%
Study Now!
XY-Copilot AI
Unlimited Access
Secure Payment
Instant Access
24/7 Support
Document Chat
Document Details
Subject
Psychology