A nurse is caring for a client who has schizophrenia.

Exhibits

The nurse is reviewing the client's medical record.

Select the "3" findings that require immediate follow-up by the nurse.

A. To treat pain and ease anxiety: The client has a history of chronic back pain due to a gymnastics injury and a previous diagnosis of anxiety. It is common for individuals with chronic pain conditions to be prescribed opioids for pain relief. Additionally, those experiencing anxiety may misuse opioids to self-medicate and achieve temporary relief from their symptoms, leading to the development of an opioid use disorder.
B. To promote sleep and rest: While some individuals may use opioids in an attempt to promote sleep, this option does not directly address the client's specific history of chronic pain and anxiety. It is less likely to be a primary reason for starting opioid use compared to treating pain and anxiety.
C. Because they witnessed their parents using drugs or alcohol to cope: Although witnessing parental substance use can influence a person's behavior, there is no indication in the provided information that the client has this background. Therefore, this is not a clear underlying reason for the client's opioid use.
D. To treat hallucinations and perform better at work: There is no mention of the client experiencing hallucinations, and the context suggests that the client is struggling academically rather than seeking to perform better at work. This option does not align with the client's situation or history.

A. Delusional disorder: Delusional disorder is characterized by the presence of false beliefs that are not consistent with reality. While some individuals with obsessive-compulsive disorder (OCD) may experience distorted thoughts, delusional disorder is not a common comorbidity associated with OCD.
B. Post-traumatic stress disorder: PTSD is a recognized comorbidity with OCD. Individuals with OCD may develop PTSD due to traumatic experiences that trigger their obsessions or compulsions, or they may have had traumatic events in their history that contribute to the development of both conditions.
C. Anorexia nervosa: While eating disorders can coexist with various mental health conditions, anorexia nervosa is not specifically linked as a common comorbidity with OCD. The relationship between OCD and eating disorders is complex, but anorexia nervosa is not a primary comorbid condition typically associated with OCD.
D. Agoraphobia: Although agoraphobia can occur alongside OCD, it is not as strongly correlated as PTSD. Agoraphobia involves the fear of being in situations where escape might be difficult or help unavailable, while OCD primarily involves intrusive thoughts and compulsive behaviors. Although both conditions can coexist, PTSD is more commonly recognized as a comorbidity.