Psych NP

Jules A, MSN · Oct 7, 2016

Are you seriously you are a psychNP with no idea how to medicate a dementia patient? Your nurses will eventually bury you if that is all you are offering up.

Aromatic · Oct 7, 2016

they have a plethora of resources that cover this topic. I wouldn't ask a random internet forum how to treat a patient. check out medscape, epocrates, uptodate, access medicine, etc.

If newly agitated id rule out some new acute processes (like UTI lol) then try a benzo then maybe antipsychotic or something. But it depends what type of dementia they got too so ill stop here.

zayrhia · Oct 7, 2016

Disclaimer: I'm not a Psych NP.

Yikes, I'm hoping this is a case study for homework in your psych NP program rather than a live patient. If you are indeed an LIP, please take Aromatic NP's advice and look up the information on one of the evidence based guidelines portals. I personally like UptoDate.

Soliloquy, MSN, APRN, NP · Oct 7, 2016

If a patient with dementia is aggressive toward staff would you give lorazepam. I don't think so but nurses are asking for something to calm her. I suggested talk to her in a calm voice. Give her maybe something that is familiar to her. Please help. Need input. Thanks

Well...You can look up information from a reputable source that said...as someone who has worked in healthcare, redirecting and alternative therapies can work in collaboration with medication.

Jules A, MSN · Oct 7, 2016

then try a benzo then maybe antipsychotic or something.

Without any knowledge of a particular case I can't say for certain but very generally speaking the OP was correct in that benzos are usually contraindicated in dementia patients. BEERS criteria

SummitRN, BSN, RN · Oct 8, 2016

2015 Beers update. Free access with registration

Geriatrics Care | Geriatric Resources | Online events | Updates - Geriatrics Care Online

Psychcns · Oct 12, 2016

OP- there are a couple of other places you could post a clinical question like this and receive more supportive responses. Send me PM if you want more info.

I think generally you have to do a complete clinical evaluation before prescribing.

PG2018 · Oct 12, 2016

Just try phenobarbital and see what happens

jwester · Nov 3, 2016

OP, define aggressive and better yet , do an in person assessment . Chemical restraints aren't a safe or ethical treatment for dementia . Perhaps the patient is acting aggressive towards staff because said patient has sundowners tendencies and doesn't want to go to bed at 8 pm so that staff can watch TV (seen it). We had a practitioner who doled out trazadone for aggression to almost every resident . Guess what ? They still wandered in the evening and were not too happy with staff who tried to keep them in their beds . Hip fractures galore from being sedated . Don't let staff bully you into writing scripts so that grandma stays in bed until am shift arrives . CNA's will pressure the RN or med nurse , and the med nurse will pressure you . If a script is warranted , carry on . But if staff is wanting patients sedated on benzos , Perhaps it's time to have a meeting and educate staff about dementia . Redirection and understanding dementia (and evening wandering ) is far more therapeutic than unnecessarily drugging someone . You're just asking for falls , incident reports , broken bones , etc . Even worse if the patient uses an assistive device . Cartwheeling over a walker or cane due to being sedated isn't an option .