A nurse is teaching a client who has a depressive disorder about fluoxetine. Which of the following information should the nurse include in the teaching?

Rationale:

A. Agoraphobia: This choice directly aligns with the client's presentation of being afraid to leave her home alone. Agoraphobia is a specific phobia characterized by an intense fear of situations that the individual perceives as inescapable or that might potentially lead to panic or embarrassment. Common triggers for agoraphobic individuals include crowded spaces, open spaces, public transportation, or being alone outside of the home. The client's inability to leave her home for weeks due to fear is a classic symptom of agoraphobia.

B. Xenophobia: This choice refers to the fear of strangers or foreigners. While the client may experience anxiety in unfamiliar situations, the primary focus of her fear is being outdoors alone rather than encountering unfamiliar people. Additionally, the daughter's description of the client's fear specifically mentions being alone, further supporting agoraphobia as the more likely diagnosis.

C. Mysophobia: This choice refers to an extreme or obsessive fear of germs or contamination. While anxiety related to cleanliness could coexist with agoraphobia, the primary presenting complaint in this case is the fear of being outdoors, not specifically germs or contamination.

D. Aerophobia: This choice refers to the fear of flying or being in high places. There is no indication in the scenario that the client's fear is specifically related to heights or flying, making this choice less likely.

Therefore, based on the specific nature of the client's fear and the limited information provided, agoraphobia is the most probable diagnosis and the one the nurse should anticipate planning care for.

Choice A rationale:

It is not accurate to state that the provider is required to notify the client's family of their admission. While providers may often choose to involve family members in the care of a client with MDD, this is not a mandatory requirement for voluntary admission.

Disclosing a client's admission without their consent could breach confidentiality and potentially damage trust between the client and healthcare team.

It's essential to respect the client's privacy and autonomy, and to obtain their permission before sharing any information with family members.

Choice C rationale:

It is incorrect to state that a client gives up their right to refuse psychotropic medications upon voluntary admission. Informed consent remains a crucial principle even in an acute mental health setting.

Clients have the right to decline medications or other treatments, even if healthcare providers believe those interventions would be beneficial.

It's important to engage in a collaborative discussion with the client, provide education about treatment options, and respect their decisions.

Choice D rationale:

It is misleading to suggest that a client cannot leave the facility until the provider completes a discharge summary and authorizes discharge.

While providers play a significant role in discharge planning, clients ultimately have the right to request discharge from voluntary admission, even if the provider does not fully agree with the decision.

Providers may need to initiate involuntary commitment procedures if a client poses a serious risk to themselves or others, but this is a separate process with specific legal requirements.

Choice B is the most accurate statement because it emphasizes the importance of informed consent throughout the treatment process. Even in a voluntary admission, clients retain their right to make decisions about their care and to be fully informed about the risks and benefits of any proposed treatments.