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The police bring an unidentified older woman into the crisis center

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The police bring an unidentified older woman into the crisis center. She is wearing handcuffs and leg shackles. She has reportedly lived in the city park for several years. She has two shopping bags of dirty clothes and other belongings. Reportedly, she has been extremely agitated, talking to herself and threatening passersby. Today, she entered a church and threw several statues. “Jane Doe” is wearing two dirty dresses, a sweater, jacket, knitted cap, unmatched socks, and dirty tennis shoes. (The temperature today is 92ºF.) Her gray hair is snarled, and she scratches her head often. She is malodorous; her breath is stale. She is thin and missing her front teeth. She appears to have a partially healed wound on her left lower leg. When asked her name, she replies, “God.” She is uncommunicative, except to demand cigarettes. When placed in a holding room, she seems fearful and moves into a far corner, striking out when anyone approaches. She refuses to sit on the bed. Ms Doe refused most of her vital signs, but her weight is 97 pounds, her pulse is 120 and respirations 22. She has a productive cough.

a. Describe ways to approach Ms Doe. What immediate nursing actions are likely? List important factors to consider when her nursing care plan is developed. (Consider short- and long-term goals.) What medical and psychiatric diagnoses are likely?

b. Describe safety measures that might be used in this client’s care.

c. What medications might be prescribed to control the client’s behavior and help make her more comfortable?

d. Identify possible community resources for Ms Doe on discharge.

e. Identify physical disorders that must be evaluated and/or ruled out in planning her care.