Author Question: When a client with a major depressive disorder states, I don't care about anything anymore, the ... (Read 74 times)

brutforce · **on:** Jul 19, 2018

When a client with a major depressive disorder states, I don't care about anything anymore, the nurse would respond:

1. You have such a good life
2. Are you feeling suicidal?
3. What about your children? They are so cute and wonderful
4. Don't worry. You'll feel better tomorrow.

Question 2

A client with chronic paranoid schizophrenia is scheduled to be discharged from the inpatient psychiatric unit in two days.

The nurse is working with the client's family to develop a plan for managing psychotic symptoms and emergency behaviors after discharge. Which of the following nursing diagnoses is most appropriate? 1. Noncompliance: Medication Regimen related to paranoid ideation
2. Self-Care Deficit: Bathing/Hygiene related to irrational thought processes
3. Knowledge Deficit: Symptom Management related to inadequate understanding of disease processes
4. Risk for Violence Directed Toward Others related to delusional and persecutory thought process

kbennett34 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

2
Rationale: Are you feeling suicidal? asks the client directly about suicide. It assesses for initial suicidal risk and the need for increased safety precautions. What about your children? They are so cute and wonderful changes the topic and a cheerful attitude about the children does not make a depressed person feel better or assess for safety needs. You have such a good life does not encourage expression of thoughts and feelings. Don't worry. You'll feel better tomorrow. offers false reassurance. The client may remain depressed and may not feel better tomorrow.

Answer to Question 2

3
Rationale: Nurses should partner with the client and family to determine a mutually agreeable plan for a safe, secure, and supportive living arrangement following discharge. This includes a plan for managing symptoms by reducing schedule demands and/or contacting the mental health team or case manager for assistance. Family members need guidance in how to recognize relapse and exacerbation of symptoms as well as what to do in an emergency situation. Noncompliance with Medications, Self-Care Deficits, and Potential for Violent Behaviors are nursing diagnoses more appropriate for clients in the inpatient setting but do not help the family prepare for challenges after discharge.