Psychiatric Medications Q 13
Nurse Bea notices a female client sitting alone in the corner smiling and talking to herself. Realizing that the client is hallucinating. Nurse Bea should:
A. Invite the client to help decorate the dayroom.
B. Leave the client alone until he stops talking.
C. Ask the client why he is smiling and talking.
D. Tell the client it is not good for him to talk to himself.
Correct Answer: B. Leave the client alone until he stops talking
This provides a stimulus that competes with and reduces hallucination. Decrease environmental stimuli when possible (low noise, minimal activity). Decrease the potential for anxiety that might trigger hallucinations. Helps calm the client. Be alert for signs of increasing fear, anxiety or agitation. Might herald hallucinatory activity, which can be very frightening to client, and client might act upon command hallucinations (harm self or others).
Option A: Explore how the hallucinations are experienced by the client. Exploring the hallucinations and sharing the experience can help give the person a sense of power that he or she might be able to manage the hallucinatory voices. Help the client to identify the needs that might underlie the hallucination. What other ways can these needs be met? Hallucinations might reflect needs for anger, power, self-esteem, and sexuality.
Option C: Keep to simple, basic, reality-based topics of conversation. Help the client focus on one idea at a time. Client’s thinking might be confused and disorganized; this intervention helps the client focus and comprehend reality-based issues. Work with the client to find which activities help reduce anxiety and distract the client from hallucinatory material. Practice new skills with the client. If clients’ stress triggers hallucinatory activity, they might be more motivated to find ways to remove themselves from a stressful environment or try distraction techniques.
Option D: Accept the fact that the voices are real to the client, but explain that you do not hear the voices. Refer to the voices as “your voices” or “voices that you hear”. Validating that your reality does not include voices can help the client cast “doubt” on the validity of their voices. Engage the client in reality-based activities such as card playing, writing, drawing, doing simple arts and crafts or listening to music. Redirecting the client’s energies to acceptable activities can decrease the possibility of acting on hallucinations and help distract from voices.