Author Question: A patient with catatonic schizophrenia has been standing with his left arm upraised and his right ... (Read 49 times)

charchew · **on:** Jul 19, 2018

A patient with catatonic schizophrenia has been standing with his left arm upraised and his right foot off the floor for the majority of the last 20 hours, eating only when allowed to eat standing up.

Which nursing intervention has priority for this patient?
a. Providing high-calorie drinks hourly
b. Assessing for lower extremity edema bid
c. Taking the patient to activities therapy once daily
d. Encouraging the patient to sit or lie down for 30 minutes hourly

Question 2

Which nursing action best addresses the needs of a paranoid patient who believes the food is poisoned?

a. Explaining that others eat the food and are not harmed
b. Allowing the patient to select food from vending machines
c. Encouraging the patient to discuss why someone would poison the food
d. Taking steps to prevent the patient from verbalizing the delusional thoughts

jojobee318 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

ANS: B
Patients 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 concerned about the pressure exerted by standing on one foot for long periods of time. Such encouragement would probably be met with resistance by the patient. High-calorie drinks would be necessary if the patient failed to eat at meals. The patient probably would not be able to cognitively process what is required to participate in activities.

Answer to Question 2

ANS: B
Patients 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 person. Delusions are fixed, false beliefs that cannot be refuted by logic. The patient will probably state that the others have been given the antidote to the poison. Encouraging discussion about the delusion is not therapeutic. Although it is wise to minimize the amount of discussion about delusions, refusing to allow the patient to speak about the delusions will not foster a therapeutic alliance.