A nurse is caring for a client who has a depressive disorder. The client states, "I don't always go to bed at night, so I get in trouble for falling asleep at work." Which of the following interventions should the nurse recommend?

Potential Condition:

a) Schizophrenia

Choice A reason: Schizophrenia is a chronic mental health condition characterized by symptoms such as delusions, hallucinations, disorganized speech, and significant social or occupational dysfunction. The client’s symptoms, including mumbling as if talking to unseen others and the belief that someone is trying to poison them, are indicative of psychotic features commonly associated with schizophrenia. The prescribed medications, clozapine and risperidone, are antipsychotics often used in the treatment of schizophrenia, further supporting this diagnosis.

Actions to Take:

d) Place the client in a room near the nurses’ station This action allows for close observation and quick intervention if the client’s condition worsens or if they exhibit behaviors that could be harmful to themselves or others.

f) Maintain the client taking their prescribed medications Continuing the prescribed antipsychotic medications is crucial for managing the symptoms of schizophrenia and preventing exacerbation of the condition.

Parameters to Monitor:

j) Command hallucinations Monitoring for command hallucinations is important as they can lead to dangerous behaviors, including harm to self or others, if the client acts on these hallucinations.

l) Suicidal ideation Patients with schizophrenia are at an increased risk for suicide, especially during acute episodes or when experiencing command hallucinations. Regular assessment for suicidal ideation is a critical component of care.

Choice A reason: Lack of empathy is not a characteristic finding in OCPD. While individuals with OCPD may appear insensitive or less responsive to the needs and feelings of others due to their focus on rules and productivity, this does not equate to a true lack of empathy.

Choice B reason: Preoccupation with details is a hallmark of OCPD. Individuals with this disorder have an excessive concern with orderliness, perfectionism, and control over their environment and tasks. They may become so involved in making every detail perfect that it can hinder task completion and efficiency.

Choice C reason: Exploitative behavior is more characteristic of other personality disorders, such as narcissistic personality disorder, and is not a typical feature of OCPD. People with OCPD are more likely to be overly conscientious and fair in their dealings with others.

Choice D reason: Excessive clinging is not typically associated with OCPD. Instead, individuals with OCPD may have difficulty delegating tasks or working with others unless things are done precisely their way, which stems from their need for control rather than a need for closeness or reassurance.