A nurse is caring for a client who is involuntarily admitted for major depressive disorder and refuses to take a prescribed oral antianxiety medication. Which of the following actions should the nurse take?
Implement consequences until the client takes the medication.
Inform the client that he does not have the right to refuse the medication.
Offer the client the medication at the next scheduled dose time.
Administer the medication to the client via IM injection.
The Correct Answer is C
A. Implement consequences until the client takes the medication:
Punitive measures should never be used in healthcare, especially in the context of mental health treatment. Coercion and punitive consequences can lead to mistrust and hinder the therapeutic relationship, which is crucial in mental health care.
B. Inform the client that he does not have the right to refuse the medication:
While it's important for the client to understand the potential consequences of refusing medication, it's also crucial to respect the client's autonomy and right to make decisions about their own treatment. Involuntary admission doesn't negate the individual's right to be informed and involved in their care decisions to the extent they are able.
C. Offer the client the medication at the next scheduled dose time:
Respecting the client's autonomy is a fundamental ethical principle in nursing care. The nurse should continue to offer the medication to the client at the scheduled times. It's essential to maintain open communication with the client, addressing concerns and attempting to build trust, which can sometimes lead to the client accepting the medication voluntarily.
D. Administer the medication to the client via IM injection:
Administering medication against a patient's will is ethically and legally questionable without proper authorization, especially if the patient is not an immediate danger to themselves or others. This approach should be avoided whenever possible.
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Related Questions
Correct Answer is B
Explanation
A. Reduced frequency of panic attacks:
ECT is not primarily used to treat panic attacks. It is more commonly employed for severe mood disorders such as major depressive disorder and bipolar disorder. While ECT might indirectly affect anxiety symptoms, its main focus is on mood stabilization and improvement of depressive symptoms.
B. Decreased feelings of hopelessness:
This is the correct choice. Decreased feelings of hopelessness, often accompanied by improved mood and reduced suicidal thoughts, indicate the effectiveness of ECT in treating severe depression. ECT is known for its rapid and significant impact on mood, leading to improvements in feelings of hopelessness and despair, which are common symptoms of severe depression.
C. Reduced frequency of seizures:
ECT itself induces controlled seizures under anesthesia as part of the treatment process. The goal of ECT is not to reduce seizures but to target specific mental health conditions, particularly severe mood disorders. ECT is not indicated for managing epilepsy or reducing the frequency of seizures related to neurological disorders.
D. Decreased fear of heights:
ECT is not a treatment specifically designed to address phobias or fear-related disorders such as acrophobia (fear of heights). It is primarily used for severe mental health conditions, especially mood disorders. While an individual's overall anxiety might improve with successful ECT treatment, its direct effect on specific phobias like fear of heights is not a primary indication for the therapy.
Correct Answer is B
Explanation
A. Contact a close relative of the client to discuss the discharge plan:
Involving close relatives or a support system can be beneficial for the client's recovery. However, it's crucial to respect the client's confidentiality and privacy. In some cases, clients might not want their relatives involved or might not have a supportive family environment, so this option should be approached cautiously and with the client's consent.
B. Refer the client to a self-help group:
This is a highly recommended action. Self-help groups like Alcoholics Anonymous (AA) provide a supportive environment where individuals with alcohol use disorder can share their experiences and coping strategies. These groups can significantly contribute to maintaining sobriety after rehabilitation.
C. Request a discharge prescription for buprenorphine for the client:
Buprenorphine is typically used to treat opioid use disorder, not alcohol use disorder. Medications like disulfiram, naltrexone, and acamprosate are more commonly prescribed to help individuals manage alcohol cravings and maintain abstinence. However, the choice of medication should be individualized and determined by a healthcare provider based on the client's specific needs and medical history.
D. Teach the client to practice systematic desensitization:
Systematic desensitization is a therapeutic technique used to treat phobias and anxieties by gradually exposing individuals to their fears in a controlled and safe manner. While it can be helpful for addressing anxiety-related issues, it's not a standard treatment for alcohol use disorder. Therapeutic interventions for alcohol use disorder often focus on behavioral therapies, counseling, and support groups.
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