A nurse is preparing to assist with applying a cast to a preschooler's arm. Which of the following actions should the nurse take?

A. Using touch to calm the client during periods of anxiety: Clients with paranoid schizophrenia may have heightened sensitivity to touch and may interpret it as threatening or intrusive. Therefore, using touch to calm the client may exacerbate their anxiety rather than alleviate it.

B. Rotating staff assignments for this client: Consistency in staff assignments can help establish trust and rapport with clients with paranoid schizophrenia. Rotating staff may disrupt this continuity and potentially increase the client's paranoia and suspicion.

C. Checking the client's mouth after the client takes medication: Clients with paranoid schizophrenia may exhibit medication non-compliance due to distrust or suspicion of medications. Checking the client's mouth after medication administration ensures that the client has ingested the medication and helps prevent hoarding or hiding of medication.

D. Assigning assistive personnel to feed the client at mealtimes: Clients with paranoid schizophrenia may have difficulty trusting others, particularly with personal activities such as feeding. Assigning assistive personnel to feed the client may increase the client's paranoia and resistance to care. It's essential to promote the client's autonomy and independence while providing support as needed.

A. "I don't care about work anymore since I was not given a promotion":

This statement demonstrates the maladaptive use of regression. Regression involves reverting to an earlier stage of development in the face of unacceptable thoughts or impulses. In this case, the client's response to not receiving a promotion is to display a lack of interest in work, which can be seen as regressing to a less mature coping mechanism.

B. "I wrote a short story about a heroic woman when I was really mad at my boss."

This statement describes the defense mechanism of sublimation rather than regression. Sublimation involves channeling unacceptable impulses or emotions into more socially acceptable activities or behaviors. In this case, the client channels their anger into writing a short story, which is a constructive and creative outlet.

C. "I still cannot remember the scene of my husband's car accident":

This statement does not demonstrate regression. Instead, it suggests repression, which involves the unconscious blocking of unpleasant memories, thoughts, or feelings from conscious awareness. The client's inability to remember the scene of the accident may indicate repression as a defense mechanism.

D. "I mentally separate myself from distractions around me when I paint on canvas."

This statement describes the defense mechanism of dissociation rather than regression. Dissociation involves a disconnection between a person's thoughts, identity, consciousness, or memory. In this case, the client mentally separates themselves from distractions while painting, which is a form of dissociative coping.