A nurse in an acute mental health facility is creating a plan of care for a new client who has histrionic personality disorder. Which of the following is the priority intervention for the nurse to make?

C. Tardive dyskinesia is a movement disorder characterized by repetitive, involuntary movements of the face, tongue, and sometimes other parts of the body. These movements can include lip smacking, tongue protrusion, grimacing, and rapid eye blinking. Tardive dyskinesia is a well-known adverse effect associated with long-term use of antipsychotic medications, particularly first- generation antipsychotics such as chlorpromazine.
A. Neuroleptic Malignant Syndrome is a rare but serious adverse reaction to antipsychotic medications, characterized by symptoms such as severe muscle rigidity, high fever, altered mental status (e.g., confusion), autonomic instability (e.g., fluctuations in blood pressure, heart rate), and elevated creatine phosphokinase (CPK) levels.
B. Dysthymia is a chronic mood disorder characterized by persistent feelings of sadness, hopelessness, and low self-esteem. Dysthymia is not directly related to the involuntary movements described in the scenario and is unlikely to be the cause of the client's symptoms.
D. Akathisia is a movement disorder characterized by inner restlessness and the inability to sit still. Akathisia is a common side effect of antipsychotic medications and can be distressing for affected individuals. However, the symptoms described in the scenario, specifically involuntary movements of the tongue and face, are more indicative of tardive dyskinesia rather than akathisia.

D. It acknowledges the client’s comfort while emphasizing the nurse’s professional role. It sets clear boundaries and reinforces that the nurse’s primary purpose is to provide care and support within the therapeutic context.

A. This response acknowledges the client’s feelings but does not set clear boundaries. It may

inadvertently encourage the client to view the nurse as a friend rather than a professional caregiver.

B. While this response establishes boundaries, it may come across as abrupt or cold. It lacks empathy and understanding.

C. This response reflects empathy and encourages further exploration of the client’s feelings. However, it does not address the professional boundaries explicitly.