Schizophrenia Q 2
A client tells the nurse that psychotropic medicines are dangerous and refuses to take them. Which intervention should the nurse use first?
A. Ask the client about any previous problems with psychotropic medications.
B. Ask the client if an injection is preferable.
C. Insist that the client takes medication as prescribed.
D. Withhold the medication until the client is less suspicious.
Correct Answer: A. Ask the client about any previous problems with psychotropic medications.
The nurse needs to clarify the client’s previous experience with psychotropic medication in order to understand the meaning of the client’s statement. 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. Explain the procedures and try to be sure the client understands the procedures before carrying them out. When the client has full knowledge of procedures, he or she is less likely to feel tricked by the staff.
Option B: Asking the client if an injection is preferable may add to the client’s suspicion and feeling threatened. Show empathy regarding the client’s feelings; reassure the client of your presence and acceptance. The client’s delusion can be distressing. Empathy conveys your caring, interest and acceptance of the client.
Option C: Insisting that the client take medication can be a violation of his right to refuse treatment. 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 D: Withholding medication prescribed to relieve delusional beliefs will likely intensify paranoid thinking. Encourage healthy habits to optimize functioning: Maintain medication regimen; maintain regular sleep pattern; maintain self-care; and reduce alcohol and drug intake. All are vital to help keep the client in remission.