A 28-year-old man is evaluated on the inpatient medical floor where he is being treated for a severe asthma exacerbation. The nursing staff reports that his behavior has been highly disruptive. During the morning shift, he told his assigned nurse that she is "the most compassionate and skilled caregiver in this entire hospital." However, later in the afternoon, he became enraged with a different nurse, yelling that she is "cruel, incompetent, and intentionally ignoring me." When the attending physician informs the patient that his respiratory status has improved and he will be discharged the following day, the patient becomes visibly furious. He threatens to stop taking all his asthma medications and walk into oncoming traffic if he is forced to leave. His past medical history is significant for multiple superficial, self-inflicted forearm lacerations and a pattern of intense, unstable romantic relationships. Which of the following are appropriate management steps for this patient? (Select all that apply)
- Schedule regular multidisciplinary team conferences to maintain a unified approach among all staffCevap
- Establish clear, consistent boundaries regarding acceptable conduct and responses to threatsCevap
- CRestrict communication about the patient's interpersonal behaviors solely to the attending physician to maintain strict confidentiality
- DStart escitalopram therapy to stabilize his rapid mood swings, presuming an underlying bipolar depressive episode
- EAdminister standing doses of haloperidol and lorazepam to prevent further emotional outbursts