A nurse is assisting in the care for a client who is exhibiting a depressed mood one week before the start of their menstrual cycle. When collecting data, the nurse should identify that the client is exhibiting manifestations consistent with which of the following disorders?

A. "Provide reassurance and comfort ensuring the client is safe." Clients with schizophrenia experiencing confusion and thought distortions require reassurance and safety measures first. Confusion can increase the risk of self-harm or agitation, making safety a priority. Comforting the client and providing a structured environment can help reduce anxiety. Ensuring a calm and safe setting supports symptom management and overall well-being.
B. "Ensure the client goes to group activities as planned." While group activities can promote socialization, a client experiencing confusion and thought distortions may struggle to participate. Forcing group engagement without addressing immediate needs can increase distress. Individualized interventions should be prioritized before encouraging group involvement. Ensuring safety and reducing anxiety are more immediate concerns.
C. "Give PRN medications to treat increased hallucinations." PRN medications may help manage symptoms but are not the first priority. Assessing and ensuring safety takes precedence before administering medications. The nurse should first provide reassurance and evaluate the severity of symptoms. Medication is important, but nonpharmacological interventions should be attempted first when possible. Ensuring safety remains the immediate concern in managing schizophrenia-related confusion.
D. "Use distraction such as the television or music." While distraction techniques can be beneficial, they do not directly address confusion or distorted thinking. The client may require more structured interventions to reorient them and provide reassurance. Music or television might help in stable periods but may not be effective in acute distress. Ensuring the client’s safety and reducing distress are higher priorities in immediate care.

A. Although you have mentioned wanting to talk today about your past abuse, let's discuss this handout I have with new coping skills. Redirecting the client away from their chosen topic disregards their needs and autonomy. Patient-centered care involves respecting the client’s concerns and prioritizing what is most meaningful to them.
B. I am going to have to change our meeting time because I need to go get lunch. Changing the meeting time based on the nurse’s personal needs rather than the client’s schedule does not align with patient-centered care. The focus should remain on the client's well-being and therapeutic relationship.
C. Let's review the goals you set today and see what your priority is this week. Reviewing client-established goals and prioritizing their needs aligns with patient-centered care. This approach fosters collaboration and empowers the client to take an active role in their recovery.
D. I would like to focus on what I believe are the best goals for you to work on. Imposing the nurse’s priorities over the client’s goals does not support patient-centered care. Instead, care should be tailored to the client's preferences, values, and recovery journey.