Psychiatric Medications Q 14
When being admitted to a mental health facility, a young female adult tells Nurse Mylene that the voices she hears frighten her. Nurse Mylene understands that the client tends to hallucinate more vividly:
A. While watching TV
B. During mealtime
C. During group activities
D. After going to bed
Correct Answer: D. After going to bed
Auditory hallucinations are most troublesome when environmental stimuli are diminished and there are few competing distractions. 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). 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.
Option A: 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. Help the client to identify times that the hallucinations are most prevalent and frightening. Helps both nurse and client identify situations and times that might be most anxiety-producing and threatening to the client.
Option B: Stay with clients when they are starting to hallucinate and direct them to tell the “voices they hear” to go away. Repeat often in a matter-of-fact manner. The client can sometimes learn to push voices aside when given repeated instructions. especially within the framework of a trusting relationship.
Option C: Decrease environmental stimuli when possible (low noise, minimal activity). Decrease the potential for anxiety that might trigger hallucinations. Helps calm the client. Work with the client to find which activities help reduce anxiety and distract the client from a 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.