A client with catatonic schizophrenia has been posturing, ...

[saliriagwu]

A client with catatonic schizophrenia has been posturing, standing with his left arm upraised and his right foot off the floor.
 
  For the most part, he ignores attempts at nursing intervention but will occasionally walk, sit, or lie down for a few minutes. The client eats standing up if the nurse brings a tray to the room. The priority nursing order would be to:
  1. Insist that client sit or lie down for 30 minutes hourly
  2. Assess for lower extremity edema bid
  3. Provide high-calorie drinks hourly
  4. Take client to activities therapy once daily

Question 2

The wife of a client newly diagnosed with paranoid schizophrenia asks the nurse, My husband was well adjusted until a month ago, and then, after a lot of work stress, he got sick. What can I expect?
 
  Will he be this sick for the rest of his life? What information can the nurse provide about prog-nosis?
  1. This disorder responds well to treatment and, with follow-up, may not recur.
  2. All types of schizophrenia are chronic relapsing disorders.
  3. Outcomes are poor related to client prehospital disorganization.
  4. The usual outcome is that only partial remission is achieved.

[qytan]

Answer to Question 1

ANS: 2
Clients who maintain one position for long periods of time should be assessed for dependent edema. In this case, the nurse would look for edema of the lower extremities and would be con-cerned about the pressure exerted by standing on one foot for long periods of time. 1. Insistence would probably be met with resistance by the client. 3. High-calorie drinks would be necessary if the client failed to eat at meals. 4. The client probably would not be able to cognitively process what is required to participate in activities.

Answer to Question 2

ANS: 1
Option 1 is a true statement about the prognosis of paranoid schizophrenia. In certain instances, the client has been productive prior to the illness and has suffered severe stress that results in on-set of illness. Good premorbid adjustment is a positive factor, suggesting a good prognosis. 2. This is not strictly the case. 3. This is truer of disorganized type schizophrenia. 4. This is truer of undifferentiated schizophrenia.