Author Question: One of the goals of therapy established with a client on a mental health unit who has been given a ... (Read 61 times)

dbose · **on:** Jul 19, 2018

One of the goals of therapy established with a client on a mental health unit who has been given a diagnosis of obsessive-compulsive disorder (OCD) is to improve his feelings of stability in his environment.

Much of his OCD behavior manifests as cleanliness and control of germs. Which nursing intervention most likely would help this client to feel more stable in his environment? a. Encouraging visits from family members and friends
b. Rewarding him for acceptable behavior by increasing the number of times he is allowed to clean his bathroom daily
c. Encouraging him to participate in group activities
d. Allowing him to wash his hands only for an agreed upon number of times daily

Question 2

The nurse is assessing a patient with chronic depression who admits to having grown increasingly despondent for the past 2 weeks; he attributes this to the likelihood of his business going bankrupt and his wife's recent filing for divorce.

Which statements merit further evaluation as possible covert expressions of suicide ideation? Select all that apply. a. I'm not sure what to do; I'm lost..
b. I only see one way out of this..
c. It will be better after tomorrow..
d. I've never felt this bad before..
e. I couldn't live without my kids..
f. Thank you for all you've done..

kaylee05 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

D
Setting limits for clients with mental health disorders helps them to feel more stable in their environment because these clients often are incapable of setting limits on their own. Encouraging family visits may be beneficial for needs of comfort and love but not for stability. Rewarding this client by allowing him to increase the number of times he may clean the bathroom does not provide for stability because it fosters inconsistency in rules and routines. Encouraging group activities is beneficial for diversional purposes and love and belonging needs but does not best address the stability issue.

Answer to Question 2

B, C, E, F
Covert clues to suicide risk are often statements that focus on an impending end or resolution, suggest that the problem will no longer exist or matter, or represent terminating with (or saying goodbye to) others. Seeing only one way out suggests he is hopeless and feels forced to take a drastic or unfortunate action (suicide). It will be better after tomorrow implies that he is going to act to end the problems before then, possibly by suicide. I couldn't live without my kids suggests he feels he must die. Thanking staff can be a way of saying goodbye, a termination action that suggests he is leaving. However, being uncertain of what to do, feeling lost, and feeling worse than ever are ways of expressing his current status (despair) and not necessarily hints that he is planning suicide.