A nurse in an acute care facility is planning care for a client with a history of alcohol use disorder who is admitted while intoxicated. Which of the following interventions should the nurse implement?

Choice A reason:
Excessive sleep or a significant change in sleep patterns can be an indicator of a relapse in schizophrenia. Schizophrenia can disrupt the regular sleep-wake cycle, leading to either insomnia or hypersomnia (excessive sleep). When a client with schizophrenia begins sleeping more than usual, it may suggest a worsening of symptoms or an impending relapse. It's essential for the nurse to include this information in the discharge teaching so that the family can monitor and seek help if the client's sleep patterns change significantly.

Choice B reason:
An inability to concentrate is another potential sign of a relapse in schizophrenia. Cognitive difficulties, including problems with concentration, are common in schizophrenia and can worsen during a relapse. This symptom can affect the client's ability to function daily and adhere to treatment plans. Therefore, it is crucial for the nurse to educate the family about this sign so they can recognize it early and consult with healthcare providers.

Choice C reason:
Exhibiting an inflated sense of self is not typically associated with schizophrenia relapse. While some individuals with schizophrenia might experience grandiose delusions, an inflated sense of self is not a common or specific sign of relapse. The family should be aware of more characteristic symptoms such as changes in sleep, concentration, mood, or behavior.

Choice D reason:
Increasing participation in social activities is generally not a sign of relapse in schizophrenia; in fact, it is often encouraged as part of the recovery process. Social withdrawal, rather than increased participation, would be more concerning and could indicate a relapse. It's important for families to support the client's social engagement as it can be beneficial for their overall well-being.

Choice A reason:
Telling a client to focus on themselves for a change may come across as dismissive and does not address the underlying feelings of hopelessness. It is important for the nurse to acknowledge the client's feelings and provide support rather than suggesting a shift in focus without understanding the root cause of their distress.

Choice B reason:
Asking the client why they feel like things will never work out can be a useful way to explore their thoughts and feelings. However, it may not be the most immediate concern if the client is experiencing severe hopelessness or suicidal ideation. The nurse should prioritize assessing the client's safety and risk of self-harm.

Choice C reason:
Asking if the client has been thinking about harming themselves is crucial in assessing their safety. Suicidal ideation is a serious concern, and it is important for the nurse to directly address this issue to determine if the client is at risk of self-harm. This response shows that the nurse is taking the client's feelings seriously and is concerned about their well-being.

Choice D reason:
Suggesting an antidepressant might make the client feel better can be helpful in the long term, but it does not address the immediate emotional distress the client is experiencing. Medication can be part of a treatment plan, but the nurse should first ensure the client's immediate safety and provide emotional support.