Author Question: A client who has been diagnosed as having paranoid schizophrenia is highly suspicious and ... (Read 45 times)

evelyn o bentley · **on:** Jul 19, 2018

A client who has been diagnosed as having paranoid schizophrenia is highly suspicious and delu-sional. He hears voices telling him terrorists are plotting to assassinate him. He refuses to eat, saying the food is poisoned.

The nursing action that best addresses his needs is to:
1. Explain that others eat the food and are not harmed
2. Allow client to select food from vending machines
3. Assist client with personal hygiene and grooming
4. Not allow client to verbalize delusional thoughts

Question 2

Because of the cognitive disturbances associated with schizophrenia, which technique will be useful as the nurse teaches a client about self-management?

1. Teach material in small segments.
2. Use only verbal instruction.
3. Plan the teaching for a time when client is stimulated and busy.
4. Offer opportunities for making a large number of choices.

alexisweber49 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

ANS: 2
Clients who think hospital food is being poisoned will sometimes eat wrapped foods that have not been opened, and occasionally, they may eat food brought from the outside by a trusted per-son. 1. Delusions are fixed, false beliefs that cannot be refuted by logic. The client will probably state that the others have been given the antidote to the poison. 3. No data exist to the effect that the client has inadequate hygiene and grooming. 4. Although it is wise to minimize the amount of discussion about delusions, refusing to allow the client to speak about the delusions will not fos-ter a therapeutic alliance.

Answer to Question 2

ANS: 1
Clients with cognitive disturbances should be taught small blocks of information at a time and given frequent reinforcement. Both verbal and visual materials should be used since processing of verbal stimuli may be more impaired. The client's symptoms should be relatively stable so that cognitive processing is maximized, and the teaching environment should be as free of extraneous stimuli as possible. A large number of choices may be confusing for the person, but a few simple choices may be included.