Asked by Wai Yip Cheng on Jun 20, 2024

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A patient with a high level of motor activity runs from chair to chair and cries, "They're coming! They're coming!" The patient is unable to follow instructions or respond to verbal interventions from staff. Which nursing diagnosis has the highest priority?

A) Risk for injury
B) Self-care deficit
C) Disturbed energy field
D) Disturbed thought processes

Disturbed Thought Processes

Alterations in thinking that manifest as errors in perception, memory, thought content, and stream of thought, often observed in conditions like schizophrenia.

Energy Field

A concept in alternative medicine that refers to a purported field surrounding living beings, believed to be a manifestation of energy related to their vitality.

Self-care Deficit

A condition in which an individual is unable to perform basic self-care activities due to physical or mental impairments.

  • Pinpoint safety precautions and first-line interventions for individuals confronting severe anxiety or panic situations.
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MM
Mandi McBroomJun 20, 2024
Final Answer :
A
Explanation :
A patient who is experiencing panic-level anxiety is at high risk for injury, related to an increase in non-goal-directed motor activity, distorted perceptions, and disordered thoughts. Existing data do not support the nursing diagnoses of self-care deficit or disturbed energy field. This patient has disturbed thought processes, but the risk for injury has a higher priority.