Author Question: A client with a borderline personality disorder tells the nurse, My doctor tells me there's ... (Read 32 times)

rmenurse

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A client with a borderline personality disorder tells the nurse, My doctor tells me there's some-thing wrong with the hard wiring of my brain, and that's why I'm so impulsive and get so many mood swings.
 
  He said he's going to prescribe some medication. Being aware of current practice guidelines, the nurse will prepare a teaching plan for:
  1. Lithium
  2. Fluoxetine
  3. Lorazepam
  4. Haloperidol

Question 2

A client with borderline personality disorder is having difficulty with memories of sexual abuse. She has a history of suicidal gestures, self-mutilation, sexual addiction, and substance addiction.
 
  She complains of vague pains, menstrual problems, and headaches. She entered the partial hospi-tal program to prevent another suicide gesture or self-mutilation. The nurse recognizes that col-laborative therapy may be helpful for this client and knows that the most useful collaboration in this case would be the client, the nurse, and the:
  1. Occupational therapist exploring ways to reduce stress
  2. Physical therapist exploring ways to reduce back pain
  3. Acupuncturist exploring ways to reduce pain
  4. Sexologist exploring healthy sexuality and safe sex



elizabethrperez

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Answer to Question 1

ANS: 2
Fluoxetine is an SSRI. SSRIs are the medications of choice for clients with personality disorder who have affect dysregulation and impulsivity. SSRIs have a low incidence of side effects. The other drugs may be used in instances of severe mood disorder (option 1), high anxiety (option 3), or violent behavior (option 4).

Answer to Question 2

ANS: 1
An occupational therapist can determine ways to increase adaptive functioning and independent living skills. Groups on stress reduction, self-awareness, and feelings are often co-led by occupa-tional therapists. Options 2 and 3: Physical therapists and acupuncturists would focus more on pain management, which is not the priority problem. Option 4: Sexual acting out is a way of managing stress, so the focus should, more properly, be on stress reduction.



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