A nurse is conducting an in-service for a group of newly licensed nurses about the interventions used for clients experiencing non-suicidal self-harm (NSSH). Which of the following should the nurse include?.

Choice A rationale:
Anxiety is a common symptom of somatic symptom disorder, as patients often experience significant distress about their physical symptoms.
Choice B rationale:
Gastrointestinal distress, such as stomach pain and diarrhea, can be manifestations of somatic symptom disorder. These symptoms can cause significant distress and disrupt daily life.
Choice C rationale:
Pain, especially when it is not linked to a clear physical cause, can be a symptom of somatic symptom disorder. The distress caused by the pain is often out of proportion to its severity.
Choice D rationale:
Bipolar disorder is a separate mental health condition and is not a symptom of somatic symptom disorder.
Choice E rationale:
Fixation on health, particularly an excessive preoccupation with physical symptoms, is a key feature of somatic symptom disorder.
Choice F rationale:
Depression can often co-occur with somatic symptom disorder, as the distress and disruption caused by the physical symptoms can lead to feelings of sadness and hopelessness.
Choice G rationale:
Localized amnesia is not a symptom of somatic symptom disorder. It is more commonly associated with other mental health conditions, such as dissociative disorders.

Choice A rationale:
Instructing the client to avoid foods with tyramine is not relevant in this case. Tyramine is associated with certain antidepressants known as MAOIs, but the client is taking Fluoxetine, which is an SSRI2.
Choice B rationale:
Applying wrist restraints might be necessary in extreme situations to ensure the client’s safety, but it should be a last resort and not the first response to self-harm.
Choice C rationale:
Offering sympathy and attention to maladaptive behavior could reinforce negative behaviors and is not recommended.
Choice D rationale:
Encouraging the client to talk about feelings prior to maladaptive behavior can be beneficial. It can help the client develop healthier coping mechanisms.
Choice E rationale:
Maintaining the same staff members caring for the client can provide consistency and stability, which can be beneficial for individuals with Borderline Personality Disorder.
Choice F rationale:
Initiating suicide precautions is crucial in this situation. The client has a history of suicidal ideation and is exhibiting self-harming behavior.
Choice G rationale:
Offering the client opportunities for physical exercise can be beneficial as it can help manage stress and improve mood.
Choice H rationale:
Exploring feelings of abandonment with the client can be beneficial. It can help the client process these feelings in a healthier way.