The patients below were evaluated in the emergency department The psychiatric unit has a bed available. which patient should be admitted?
Explanation & Rationale
Choice A reason: This patient is experiencing a normal grief reaction or adjustment disorder following a significant life stressor. While the patient feels sadness and anxiety, there is no indication of a loss of reality testing, inability to care for self, or immediate risk of harm to self or others. Choice B reason: These are common extrapyramidal side effects of first-generation antipsychotics. Dry mouth and tremors are manageable in an outpatient setting by adjusting the medication dosage or adding an anticholinergic agent like benztropine. These symptoms do not constitute a psychiatric emergency requiring acute inpatient hospitalization for stabilization. Choice C reason: Command hallucinations directed toward harming a vulnerable infant represent a high-risk psychiatric emergency. This patient requires immediate admission to ensure the safety of the child and to begin intensive pharmacological and therapeutic intervention for postpartum psychosis or a similar severe psychotic disorder. Choice D reason: While self-harm is serious, a superficial cut following a specific argument may indicate a maladaptive coping mechanism rather than an acute suicidal intent. This patient might be stabilized in the emergency department and referred to intensive outpatient therapy unless further assessment reveals active suicidal ideation.