A nurse is assessing a client who is disoriented to time and place. What additional findings would support a diagnosis of delirium? (Select all that apply.)

Choice A Reason:

Seclusion is used in psychiatric settings primarily to manage patients who are exhibiting aggressive or severely disturbed behavior. The reduced sensory input in a seclusion room helps the patient to regain control over their emotions and behavior by minimizing external stimuli that could exacerbate their condition. This controlled environment can be crucial in preventing harm to the patient and others, and it allows the patient to calm down in a safe space. The goal is to provide a therapeutic setting that aids in the patient’s recovery and stabilization.

Choice B Reason:

While communication is an essential part of psychiatric care, seclusion is not intended to encourage interaction with others. In fact, seclusion is used when a patient needs to be isolated to prevent harm to themselves or others. Encouraging communication is more appropriate in other therapeutic settings where the patient is stable and can engage safely with others. Therefore, this statement does not accurately explain the purpose of seclusion.

Choice C Reason:

Forcing clients to be responsible for themselves is not the primary goal of seclusion. Seclusion is a measure taken to ensure safety and to help the patient regain control over their behavior in a controlled environment. Responsibility and self-management are important aspects of psychiatric treatment, but they are typically addressed through other therapeutic interventions and not through seclusion. Thus, this statement is not an accurate explanation of the use of seclusion.

Choice D Reason:

Managing the unit with fewer staff is not a valid reason for using seclusion. The primary purpose of seclusion is to ensure the safety of the patient and others, not to reduce staffing needs. In fact, the use of seclusion requires careful monitoring and adherence to strict protocols, which can actually increase the need for staff attention. Therefore, this statement does not correctly explain the rationale behind the use of seclusion.

Choice A Reason: Assess regularly for self-harm during treatment

Regular assessment for self-harm is crucial in any psychiatric care plan, especially for clients with conversion disorder who may experience significant distress. However, this action alone does not address the underlying issues or provide the client with tools to manage their symptoms. Continuous monitoring is important, but it should be part of a broader, more comprehensive care plan.

Choice B Reason: Allow for unlimited discussion on physical symptoms

While it is important to validate the client’s experiences and provide a space for them to discuss their symptoms, allowing unlimited discussion can sometimes reinforce the symptoms and lead to increased focus on physical complaints. This approach may not be beneficial in the long term and can detract from addressing the psychological aspects of the disorder.

Choice C Reason: Discuss alternative coping strategies with the client

This is the correct answer. Discussing alternative coping strategies helps the client develop skills to manage their symptoms more effectively. Techniques such as cognitive-behavioral therapy (CBT), relaxation exercises, and stress management can be very beneficial. These strategies empower the client to handle stress and reduce the impact of their symptoms. Providing education on coping mechanisms is a proactive approach that can lead to better outcomes.

Choice D Reason: Encourage alone time for the client in seclusion

Encouraging alone time in seclusion is generally not recommended for clients with conversion disorder. Seclusion can increase feelings of isolation and distress, potentially exacerbating symptoms. Instead, supportive and interactive interventions are preferred to help the client feel connected and understood.