A nurse is caring for a client who has a personality disorder. Which of the following statements made by the client indicate they are coping with the maladaptive defense mechanism of displacement?

A. Ensure the client's room is dark at night: A dark room can increase confusion and agitation in clients with dementia, especially at night. It’s important to provide a well-lit environment to reduce confusion and help the client maintain a sense of orientation.
B. Use symbols to assist the client in finding personal items: Using symbols, pictures, or labels to help the client identify personal items can provide orientation and reduce frustration. This approach supports independence while minimizing confusion.
C. Ask the client orientation questions many times per day: Asking orientation questions repeatedly can increase anxiety and confusion for clients with dementia. It’s more effective to provide reassurance and support rather than focusing on constant questioning of orientation.
D. Provide a high level of sensory stimulation during the day: While some level of stimulation is important, excessive sensory input can overwhelm or agitate a client with dementia. The environment should be calm and soothing to avoid overstimulation.

Rationale for correct choices:

• Ask a trusted person to watch for manifestations of illness: Involving a trusted person in monitoring symptoms can help identify early signs of relapse. Sometimes, clients may not notice subtle changes in their mental state, so a reliable individual can alert the healthcare provider, allowing for early intervention.
• Notify your provider within 48 hr of manifestations of a relapse: Early detection and intervention are key to preventing a full relapse. By notifying the provider within 48 hours, the healthcare team can adjust medications or other interventions promptly, reducing the severity of symptoms.
• Go for a walk to decrease anxiety during times of increased stress: Physical activity, like walking, is beneficial for managing anxiety, which is a common trigger in individuals with schizophrenia. Regular exercise can also promote mental well-being, making it a helpful strategy for coping with stress.
• Report any adverse effects of the medication to the provider immediately: Antipsychotic medications like haloperidol can cause significant side effects, and reporting these early allows the provider to manage or adjust the treatment plan, preventing complications such as extrapyramidal symptoms or neuroleptic malignant syndrome.

Rationale for incorrect choices:

• Limit alcohol consumption to no more than two drinks per week: Alcohol should be avoided entirely, as it can interfere with the effectiveness of antipsychotic medications and worsen psychiatric symptoms.
• Take a dose of the medication as soon as delusions or hallucinations begin: Medications for schizophrenia, like haloperidol, should be taken as prescribed, and adjustments to dosage or frequency should only be made under the guidance of a healthcare provider.