1400: Client was brought to the psychiatric ED by his parents for acting 'bizarre.' Apparently, the client was visiting his parents and was disheveled, not oriented, and stated 'something is out to get me.' The client has a medical history of schizophrenia, and it is unknown if the client has been adherent to his prescribed antipsychotic. Vital signs: T 97° F (36° C), P 87, RR 19, BP 154/86, pulse oximetry reading 98% on room air. On assessment, the client is alert and completely disoriented, repeating, 'something is out to get me' the client does not identify what is out to get him when asked. The client cooperative with some questions but became hostile later towards the end of the assessment. Speech latency was noted with normal volume. The client denies suicidal ideations. Intense eye contact was noted. Parents at the bedside.

1440: IM olanzapine was administered to the client without any resistance. Obtained ordered laboratory work. Call bell within reach.

1550: Parents alerted RN to the client 'needing help'. The client was assessed and was noted to have intermittent spasmodic contractions of the neck. The client stated 'my neck, my neck.' The client was disoriented and agitated. Vital signs: T 97° F (36° C), P 101, RR 18, BP 145/79, pulse oximetry reading 98% on room air.

1430:

• Admit to inpatient psychiatry for psychosis
• Involuntary admission status
• Regular diet
• Vital signs per unit standard
• Consult inpatient psychiatry
• Obtain urine drug screen (UDS) and complete blood count (CBC)
• Olanzapine 10 mg intramuscular (IM), first dose now