Schizophrenia Q 10
Since admission 4 days ago, a client has refused to take a shower, stating, “There are poison crystals hidden in the showerhead. They’ll kill me if I take a shower.” Which nursing action is most appropriate?
A. Dismantling the showerhead and showing the client that there is nothing in it.
B. Explaining that other clients are complaining about the client’s body odor.
C. Asking a security officer to assist in giving the client a shower.
D. Accepting these fears and allowing the client to take a sponge bath.
Correct Answer: D. Accepting these fears and allowing the client to take a sponge bath
By acknowledging the client’s fears, the nurse can arrange to meet the client’s hygiene needs in another way. Attempt to understand the significance of these beliefs to the client at the time of their presentation. Important clues to underlying fears and issues can be found in the client’s seemingly illogical fantasies. Recognize the client’s delusions as the client’s perception of the environment. Recognizing the client’s perception can help you understand the feelings he or she is experiencing.
Option A: Because these fears are real to the client, providing a demonstration of reality wouldn’t be effective at this time. Interact with clients on the basis of things in the environment. Try to distract the client from their delusions by engaging in reality-based activities (e.g., card games, simple arts and crafts projects etc). When thinking is focused on reality-based activities, the client is free of delusional thinking during that time. Helps focus attention externally.
Option B: Initially do not argue with the client’s beliefs or try to convince the client that the delusions are false and unreal. Arguing will only increase a client’s defensive position, thereby reinforcing false beliefs. This will result in the client feeling even more isolated and misunderstood.
Option C: These would violate the client’s rights by shaming or embarrassing the client. Do not touch the client; use gestures carefully. Suspicious clients might misinterpret touch as either aggressive or sexual in nature and might interpret it as a threatening gesture. People who are psychotic need a lot of personal space.