A nurse is preparing to administer diphenhydramine 50 mg PO every 6 hr to a client who has acute dystonia. The available medication is diphenhydramine 25 mg tablets.

How many tablets should the nurse administer per dose?

Choice A rationale: Feeling too tired to attend a group meeting does not necessarily indicate anxiety. It could be due to various reasons such as lack of sleep, side effects of medication, or lack of motivation, which are not indications for administering lorazepam.

Choice B rationale: Seeing “purple bugs crawling on the wall” is a hallucination, which is a symptom of schizophrenia, not anxiety. Lorazepam is not typically used as the first-line treatment for hallucinations.

Choice C rationale: Believing that he is a government agent is a delusion, which is a symptom of schizophrenia. Lorazepam is not typically used as the first-line treatment for delusions.

Choice D rationale: “My heart is pounding out of my chest” is a common symptom of anxiety. It indicates that the client might be experiencing physiological symptoms of anxiety such as increased heart rate and palpitations. In this case, administering lorazepam, which is an anxiolytic medication, would be appropriate.

In conclusion, the nurse should consider administering lorazepam when the client states, “My heart is pounding out of my chest.”

Lorazepam is a medication belonging to the benzodiazepine class, commonly used to treat anxiety and insomnia. It works by slowing down the activity in the brain and nervous system, producing a calming effect.

Generalized Anxiety Disorder (GAD) is a chronic mental health condition characterized by excessive worry and anxiety that persists for at least 6 months, interfering with daily life.

Important Considerations:

Lorazepam is a controlled substance due to its potential for abuse and dependence.

It should only be administered under the supervision of a qualified healthcare professional, who can assess the individual's needs and potential risks.

Self-treating with lorazepam is dangerous and can lead to serious consequences.

If you have concerns about anxiety or are considering using lorazepam, please consult a licensed physician or mental health professional for proper diagnosis and treatment guidance.

Remember,

Choice A rationale:

Anxiety reduction is the core motivation for ritualistic behaviors in OCD. Individuals with OCD experience intrusive, distressing thoughts (obsessions) that trigger intense anxiety. To neutralize this anxiety, they engage in repetitive behaviors (compulsions) that provide temporary relief.

The relief is often short-lived, leading to a cycle of obsessions and compulsions. This cycle can become debilitating and significantly impair daily functioning.

Research supports the anxiety-reduction model of OCD. Studies have shown that engaging in compulsions reduces anxiety in individuals with OCD, both subjectively and physiologically.

Neuroimaging studies have also demonstrated that ritualistic behaviors activate brain regions involved in anxiety and fear processing. This suggests that compulsions have a direct effect on the brain's anxiety circuitry.

Choice B rationale:

Sexual satisfaction is not a typical motivation for ritualistic behaviors in OCD. While some compulsions may have a sexual component (e.g., checking for arousal), the primary goal is to reduce anxiety, not to achieve sexual gratification.

Choice C rationale:

Feelings of shame may be associated with OCD, but they are not the primary driving force behind ritualistic behaviors. Shame often arises from the content of obsessions (e.g., thoughts about contamination, harm, or taboo subjects) or the perceived social stigma of OCD. However, the urge to perform compulsions stems from the need to alleviate anxiety, not to decrease shame.

Choice D rationale:

Boosting self-esteem is not a common motivation for ritualistic behaviors in OCD. In fact, many individuals with OCD experience low self-esteem due to the impact of the disorder on their lives. Compulsions may provide a temporary sense of control or mastery, but they do not typically lead to lasting improvements in self-esteem.