Schizophrenia Q 65
Ramsay is diagnosed with schizophrenia paranoid type and is admitted to the psychiatric unit of Nurseslabs Medical Center. Which of the following nursing interventions would be most appropriate?
A. Establishing a non-demanding relationship.
B. Encouraging involvement in group activities.
C. Spending more time with Ramsay.
D. Waiting until Ramsay initiates interaction.
Correct Answer: A. Establishing a non-demanding relationship
A non-threatening, non-demanding relationship helps decrease the mistrust that is common in a client with paranoid schizophrenia. Use a non-judgemental, respectful, and neutral approach with the client. There is less chance for a suspicious client to misinterpret intent or meaning if content is neutral and approach is respectful and non-judgemental.
Option B: Maintain a low level of stimuli and enhance a non-threatening environment (avoid groups). Noisy environments might be perceived as threatening. Initially, provide solitary, non-competitive activities that take some concentration. Later a game with one or more the client takes concentration (e.g., chess checkers, thoughtful card games such as ridge or rummy). If a client is suspicious of others, solitary activities are the best. Concentrating on environmental stimuli minimizes paranoid rumination.
Option C: Spending more time with the client would be threatening for a client who is suspicious of other people’s motives. Set limits in a clear matter-of-fact way, using a calm tone. “Giving threatening remarks to Jeremy is unacceptable. We can talk more about the proper ways in dealing with your feelings”. A calm and neutral approach may diffuse the escalation of anger. Offer an alternative to verbal abuse by finding appropriate ways to deal with feelings.
Option D: This client is unlikely to initiate interaction; the nurse is responsible for initiating a relationship with the client. Be honest and consistent with the client regarding expectations and enforcing rules. Suspicious people are quick to discern honesty. Honesty and consistency provide an atmosphere in which trust can grow.