Schizophrenia Q 8
The nurse is caring for a client with schizophrenia. Which of the following outcomes is the least desirable?
A. The client spends more time by himself.
B. The client doesn’t engage in delusional thinking.
C. The client doesn’t harm himself or others.
D. The client demonstrates the ability to meet his own self-care needs.
Correct Answer: A. The client spends more time by himself.
The client with schizophrenia is commonly socially isolated and withdrawn; therefore, having the client spend more time by himself wouldn’t be a desirable outcome. Rather, a desirable outcome would specify that the client spends more time with other clients and staff on the unit. Delusions are false personal beliefs. Eventually engage other clients and significant others in social interactions and activities with the client (card games, ping pong, sing-a-songs, group sharing activities) at the client’s level. Client continues to feel safe and competent in a graduated hierarchy of interactions.
Option B: Reducing or eliminating delusional thinking using talking therapy and antipsychotic medications would be a desirable outcome. If the client is delusional/hallucinating or is having trouble concentrating at this time, provide very simple concrete activities with the client (e.g., looking at a picture or doing a painting). Even simple activities help draw the client away from delusional thinking into reality in the environment.
Option C: Protecting the client and others from harm is a desirable client outcome achieved by close observation, removing any dangerous objects, and administering medications. Ensure that the goals set are realistic; whether in the hospital or community. Avoids pressure on the client and sense of failure on part of the nurse/family. This sense of failure can lead to mutual withdrawal.
Option D: Because the client with schizophrenia may have difficulty meeting his or her own self-care needs, fostering the ability to perform self-care independently is a desirable client outcome. Remember to give acknowledgement and recognition for positive steps the client takes in increasing social skills and appropriate interactions with others. Recognition and appreciation go a long way to sustaining and increasing a specific behavior.