A nurse is caring for a client in an intensive care unit. The client develops delirium while recovering from surgery. To promote safety, which of the following actions should the nurse take?

Choice A Reason:
Exploitative behavior is more commonly associated with narcissistic personality disorder rather than obsessive-compulsive personality disorder (OCPD). Individuals with narcissistic personality disorder often manipulate and exploit others to achieve their own goals and maintain their self-esteem. This behavior is not characteristic of OCPD, which is more focused on orderliness, perfectionism, and control.

Choice B Reason:
Lack of empathy is a hallmark of antisocial personality disorder and narcissistic personality disorder. Individuals with OCPD may have difficulty understanding others' emotions due to their rigid thinking and focus on rules, but they do not typically exhibit a complete lack of empathy. Their interactions are more characterized by a need for control and perfectionism rather than a disregard for others' feelings.

Choice C Reason:
Excessive clinging is a symptom more commonly associated with dependent personality disorder. Individuals with dependent personality disorder have an excessive need to be taken care of, leading to submissive and clinging behaviors. In contrast, those with OCPD are more focused on maintaining control and order in their environment and relationships, rather than exhibiting dependency.

Choice D Reason:
Preoccupation with details is a core feature of obsessive-compulsive personality disorder. Individuals with OCPD are excessively focused on rules, schedules, and details to the extent that it interferes with their ability to complete tasks and maintain flexibility. This preoccupation often leads to inefficiency and difficulty in adapting to new situations, as they are overly concerned with perfectionism and control.

Choice A Reason:
Offering the medication at the next scheduled dose time respects the client's autonomy and right to refuse treatment. Even though the client is involuntarily admitted, they still retain certain rights, including the right to refuse medication. The nurse should document the refusal and offer the medication again at the next scheduled time, ensuring that the client understands the importance and benefits of the medication. This approach maintains a therapeutic relationship and encourages the client to participate in their own care.

Choice B Reason:
Implementing consequences until the client takes the medication is not an appropriate or ethical approach. This method can be coercive and may damage the therapeutic relationship between the nurse and the client. It is important to respect the client's autonomy and work collaboratively to address their concerns and encourage adherence to the treatment plan.

Choice C Reason:
Administering the medication via IM injection without the client's consent is not appropriate unless there is an immediate risk to the client's safety or the safety of others. Forced medication should only be used as a last resort and in accordance with legal and ethical guidelines. The nurse should first attempt to address the client's concerns and encourage voluntary compliance with the prescribed treatment.

Choice D Reason:
Informing the client that they do not have the right to refuse the medication is incorrect and violates the client's rights. Even involuntarily admitted clients have the right to refuse treatment, except in certain emergency situations where the client poses a danger to themselves or others. The nurse should provide education about the medication and its benefits, and respect the client's decision while continuing to offer support and encouragement.