Your patient is a 45-year-old male with a history of bipolar disorder. He is sitting at the kitchen table, conscious, alert, and oriented. He is pleasant and greets you as you walk in. The patient's wife called EMS because he has refused to take his lithium and is "driving her crazy with his hyperactive attitude." She insists that you transport him to the hospital. The patient admits to voluntary noncompliance with his lithium, stating, "I didn't like the way it made me feel." He denies any suicidal thoughts and states that he has not felt "this good for a long time." He is curious about your job and wants to know how he could get into a paramedic class. He states that he's also thinking about going to law school but wants to finish his Ph.D. first. The physical examination is unremarkable. HR = 82, BP = 122/80, RR = 10, SaO₂ = 99%. He says, "See, I told you I'm fine. I don't need to go to the hospital." Which of the following is the best course of action?

Question

Quizplus · Accepted Answer

Contacting medical direction is the best course of action because the patient is alert, oriented, and not exhibiting behavior that immediately endangers himself or others. This allows for professional guidance on how to proceed given the patient's refusal to take medication and the lack of immediate psychiatric crisis.

Your Patient Is a 45-Year-Old Male with a History of Bipolar