Author Question: The nurse manager of the inpatient psychiatric unit is talking with the staff about the ... (Read 108 times)

newbem · **on:** Jul 19, 2018

The nurse manager of the inpatient psychiatric unit is talking with the staff about the interventions to promote independent actions of clients on the chronic schizophrenia unit.

Which of the following responses made by the staff indicates lack of insight into the client's illness? 1. I want to learn more about the side effects of the medication.
2. I know when clients hear voices they are not real.
3. I understand that some clients are not able to put on their clothes.
4. I believe clients sometimes need to be isolated help them feel safe.

Question 2

The client with schizophrenia was started on imipramine (Tofranil) for a depressed mood and subsequently started hearing voices again and refuses to take the Tofranil because the client thinks it is poison.

The nursing response is based on what information? 1. Tricyclic antidepressants can trigger overt symptoms in someone with schizophrenia.
2. There is no evidence that tricyclic antidepressants trigger psychotic symptoms in susceptible clients.
3. Often new antipsychotic medications like imipramine have paradoxical effects.
4. MAOIs do not interact well with other antipsychotic medications and can cause worsening of symptoms.

aprice35067 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

2
Rationale: A hallucination is a real experience to the individual To maintain a therapeutic relationship, the nurse should convey acceptance of the client's experience. Acknowledging disbelief of the auditory hallucination may affect the nurse's ability to engage in a therapeutic nurseclient relationship. Clients who are low functioning may benefit from assistance with their activities of daily living, such as assisting with dressing. A client who is at risk for harming self or others may need to be isolated to help him or her feel safe by minimizing access to potentially harmful objects. Nurses need to be informed of potential side effects of medications in order to monitor for side effects and instructing others.

Answer to Question 2

1
Rationale: Tricyclic antidepressants (TCAs) can trigger overt symptoms in clients with schizophrenia. TCAs, such as imipramine, are not antipsychotic medications. Imipramine is not an MAOI.