A nurse is caring for a client who has schizophrenia. The client is in the dayroom and shouting at other clients, stating, “Do not eat the food here. The staff is poisoning the food!” The nurse should document that the client is experiencing which type of delusion?

Choice A Reason:

Clozapine is known to cause agranulocytosis, a potentially life-threatening condition where the white blood cell count drops significantly, leading to a higher risk of infection. Patients on clozapine must have regular blood tests to monitor their white blood cell count. Any signs of infection, such as fever, sore throat, or flu-like symptoms, should be reported to a physician immediately as they could indicate agranulocytosis.

Choice B Reason:

A decrease in hallucinations is generally a positive sign indicating that the medication is working effectively. It is not a reason to call the physician immediately. Instead, this should be discussed during regular follow-up appointments to assess the overall effectiveness of the treatment.

Choice C Reason:

While a decrease in appetite can be a side effect of clozapine, it is not typically an emergency unless it leads to significant weight loss or malnutrition. This should be monitored and discussed with the physician during regular visits. If the decrease in appetite is severe or persistent, it may warrant a call to the physician, but it is not as urgent as signs of infection.

Choice D Reason:

Insomnia can occur with clozapine use, but it is usually managed with adjustments to the medication regimen or additional treatments for sleep. While it is important to address insomnia, it does not require immediate medical attention unless it severely impacts the patient’s well-being.

Choice A Reason:

Restating involves repeating what the client has said in order to show understanding and to encourage them to continue talking. This technique helps to clarify the client’s thoughts and feelings, ensuring that the nurse accurately understands the client’s message. It also demonstrates active listening and empathy, which are crucial components of therapeutic communication.

Choice B Reason:

Giving advice is generally considered a non-therapeutic communication technique. It can imply that the nurse knows best and can undermine the client’s autonomy and decision-making abilities. Instead of giving advice, therapeutic communication focuses on helping clients explore their own thoughts and feelings to arrive at their own conclusions and solutions.

Choice C Reason:

Maintaining neutral responses involves responding to the client in a way that does not convey judgment or bias. This technique helps to create a safe and supportive environment where the client feels comfortable sharing their thoughts and feelings. Neutral responses can include nodding, making non-committal sounds like “mm-hmm,” and using phrases like “I see” or “Tell me more”.

Choice D Reason:

Asking the client “Why?” can be perceived as confrontational or judgmental, which can hinder open communication. It may make the client feel defensive or uncomfortable. Instead, therapeutic communication techniques involve asking open-ended questions that encourage the client to express themselves without feeling judged.

Choice E Reason:

Listening is one of the most fundamental therapeutic communication techniques. It involves giving the client your full attention, showing interest in what they are saying, and responding appropriately to their concerns. Active listening helps to build trust and rapport, making the client feel heard and understood.