A female client on the mental health unit experiences periods of ...

[geodog55]

A female client on the mental health unit experiences periods of psychosis at intervals. She often asks what day she came to the facility and what day it is now, and she seems never to be aware of the time.
 
  Which nursing intervention would help this client the most? a. Remind her of the time of day every time she asks.
  b. Assist her to keep a written schedule, including her day of admission, on a calendar posted in her room and a clock beside the calendar.
  c. Tell her it doesn't really matter what day she came to the facility; what matters is what day and time it is now.
  d. Instruct the staff to not answer her repetitive questions because she has been told numerous times her day of admission, and there is a clock on the wall.

Question 2

Which statement accurately differentiates NCD from pseudodementia (depression)?
 
  1. NCD has a rapid onset, whereas pseudodementia does not.
  2. NCD symptoms include disorientation to time and place, and pseudodementia does not.
  3. NCD symptoms improve as the day progresses, but symptoms of pseudodementia worsen.
  4. NCD causes decreased appetite, whereas pseudodementia does not.

[al]

Answer to Question 1

B
A written schedule in her room and a clock will assist her in learning to monitor this information on her own, and this will help to keep her oriented and will foster independence. Reminding her of the time will not help the client monitor the time on her own; it allows the ineffective cycle to continue. Telling the client that it doesn't matter when she entered the facility and instructing the staff not to answer her questions are belittling to the client.

Answer to Question 2

2
Rationale: NCD has a slow progression of symptoms, whereas pseudodementia has a rapid progression of symptoms. NCD symptoms include disorientation to time and place, and pseudodementia does not. NCD symptoms' severity worsens as the day progresses, whereas in pseudodementia, symptoms improve as the day progresses. In NCD the appetite remains unchanged. whereas in pseudodementia, the appetite diminishes.