Schizophrenia Q 9
The nurse formulates a nursing diagnosis of Impaired verbal communication for a client with schizotypal personality disorder. Based on this nursing diagnosis, which nursing intervention is most appropriate?
A. Helping the client to participate in social interactions.
B. Establishing a one-on-one relationship with the client.
C. Establishing alternative forms of communication.
D. Allowing the client to decide when he wants to participate in verbal communication with the nurse.
Correct Answer: B. Establishing a one-on-one relationship with the client
By establishing a one-on-one relationship, the nurse helps the client learn how to interact with people in new situations. Assess if incoherence in speech is chronic or if it is more sudden, as in an exacerbation of symptoms. Establishing a baseline facilitates the establishment of realistic goals, the foundation for planning effective care.
Option A: Plan short, frequent periods with a client throughout the day. Short periods are less stressful, and periodic meetings give a client a chance to develop familiarity and safety. Keep voice in a low manner and speak slowly as much as possible. A high-pitched/loud tone of voice can elevate anxiety levels while slow speaking aids understanding.
Option C: Keep the environment calm, quiet and as free of stimuli as possible. Keep anxiety from escalating and increasing confusion and hallucinations/delusions. Use clear or simple words, and keep directions simple as well. The client might have difficulty processing even simple sentences. Use simple, concrete, and literal explanations. Minimizes misunderstanding and/or incorporating those misunderstandings into delusional systems.
Option D: The other options are appropriate but should take place only after the nurse-client relationship is established. Use therapeutic techniques (clarifying feelings when speech and thoughts are disorganized) to try to understand the client’s concerns. Even if the words are hard to understand, try getting to the feelings behind them. When you do not understand a client, let him/her know you are having difficulty understanding. Pretending to understand limits your credibility in the eyes of your client and lessens the potential for trust.