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Low self-esteem is a negative evaluation of one's self-worth, often associated with depression. Clients with low self-esteem may exhibit behaviors such as making negative statements about themselves, expressing dissatisfaction with their appearance and abilities, avoiding eye contact and speaking in a low voice, and having difficulty accepting compliments or praise.

Group therapy is a form of psychotherapy that involves one or more therapists working with several clients who share a common problem or goal. Group therapy can help clients with anxiety disorders by providing social support, education, coping skills, and exposure to feared situations. To facilitate effective communication and interaction among the group members, the nurse should use strategies such as establishing clear and consistent rules and expectations for the group, encouraging active participation and feedback from all group members, and using open-ended questions and reflective statements to elicit responses.

"That must be very frightening for you. How can I help you feel safe?"

Rationale: Hallucinations are sensory perceptions that occur without external stimuli, often associated with schizophrenia. Clients who experience auditory hallucinations may hear voices that are threatening, derogatory, or commanding. The nurse should respond to the client's hallucinations with empathy, respect, and validation, while also assessing their risk for self-harm or harm to others. The nurse should also help the client cope with their hallucinations by providing distraction, reality orientation, medication administration, and environmental modification.

Autonomy is the ability to act independently and make choices based on one's own values and beliefs. Respect for autonomy is an ethical principle that guides the nurse-client relationship, especially in mental health settings. The nurse should demonstrate respect for the client's autonomy by informing the client about their diagnosis and treatment options, asking the client for their preferences and opinions regarding their care, and encouraging the client to participate in decision-making and goal-setting.

Mood is the subjective emotional state that the client experiences and reports. Mood can be assessed by asking the client how they feel today, or by using standardized scales such as the Hamilton Rating Scale for Depression or the Patient Health Questionnaire-9. Mood can be described using terms such as happy, sad, angry, anxious, or indifferent.

Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI) that is used to treat OCD and other anxiety disorders. SSRIs work by increasing the availability of serotonin in the brain, which helps regulate mood, anxiety, and compulsive behaviors. The nurse should include the following information in the teaching:

- The medication should be taken with food to prevent stomach upset, nausea, or vomiting.

- The medication should not be taken with alcohol, as this can increase the risk of adverse effects such as drowsiness, dizziness, or liver damage.

- The medication may cause sexual dysfunction as a side effect, such as decreased libido, erectile dysfunction, or delayed ejaculation. The client should report any changes in sexual function to their provider.

Teach the client relaxation techniques such as deep breathing or progressive muscle relaxation.

Rationale: Flashbacks are vivid and intrusive recollections of a traumatic event that occur involuntarily and cause distress to the client. Flashbacks can be triggered by reminders of the trauma, such as sights, sounds, smells, or emotions. The nurse should help the client cope with flashbacks by teaching them relaxation techniques such as deep breathing or progressive muscle relaxation, which can help reduce anxiety and physiological arousal. The nurse should also stay with the client until they are calm and oriented.