A nurse is caring for a client who is involuntarily admitted for major depressive disorder and refuses to take a prescribed oral antianxiety medication. Which of the following actions should the nurse take?
Implement consequences until the client takes the medication.
Inform the client that he does not have the right to refuse the medication.
Offer the client the medication at the next scheduled dose time.
Administer the medication to the client via IM injection.
The Correct Answer is C
A. Implement consequences until the client takes the medication:
Punitive measures should never be used in healthcare, especially in the context of mental health treatment. Coercion and punitive consequences can lead to mistrust and hinder the therapeutic relationship, which is crucial in mental health care.
B. Inform the client that he does not have the right to refuse the medication:
While it's important for the client to understand the potential consequences of refusing medication, it's also crucial to respect the client's autonomy and right to make decisions about their own treatment. Involuntary admission doesn't negate the individual's right to be informed and involved in their care decisions to the extent they are able.
C. Offer the client the medication at the next scheduled dose time:
Respecting the client's autonomy is a fundamental ethical principle in nursing care. The nurse should continue to offer the medication to the client at the scheduled times. It's essential to maintain open communication with the client, addressing concerns and attempting to build trust, which can sometimes lead to the client accepting the medication voluntarily.
D. Administer the medication to the client via IM injection:
Administering medication against a patient's will is ethically and legally questionable without proper authorization, especially if the patient is not an immediate danger to themselves or others. This approach should be avoided whenever possible.
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Related Questions
Correct Answer is B
Explanation
A. Reduced frequency of panic attacks:
ECT is not primarily used to treat panic attacks. It is more commonly employed for severe mood disorders such as major depressive disorder and bipolar disorder. While ECT might indirectly affect anxiety symptoms, its main focus is on mood stabilization and improvement of depressive symptoms.
B. Decreased feelings of hopelessness:
This is the correct choice. Decreased feelings of hopelessness, often accompanied by improved mood and reduced suicidal thoughts, indicate the effectiveness of ECT in treating severe depression. ECT is known for its rapid and significant impact on mood, leading to improvements in feelings of hopelessness and despair, which are common symptoms of severe depression.
C. Reduced frequency of seizures:
ECT itself induces controlled seizures under anesthesia as part of the treatment process. The goal of ECT is not to reduce seizures but to target specific mental health conditions, particularly severe mood disorders. ECT is not indicated for managing epilepsy or reducing the frequency of seizures related to neurological disorders.
D. Decreased fear of heights:
ECT is not a treatment specifically designed to address phobias or fear-related disorders such as acrophobia (fear of heights). It is primarily used for severe mental health conditions, especially mood disorders. While an individual's overall anxiety might improve with successful ECT treatment, its direct effect on specific phobias like fear of heights is not a primary indication for the therapy.
Correct Answer is C
Explanation
A. Prepare the client for electroconvulsive therapy:
Electroconvulsive therapy (ECT) is not a standard or appropriate treatment for anorexia nervosa. ECT is primarily used for severe depression, bipolar disorder, and certain other mental health conditions. Anorexia nervosa is typically managed through psychotherapy, nutritional counseling, and medical monitoring, often in an outpatient or inpatient setting, depending on the severity of the disorder.
B. Weigh the client twice per day:
Frequent weighing is generally discouraged in the treatment of anorexia nervosa. Individuals with this disorder often have an unhealthy fixation on their weight. Frequent weigh-ins can exacerbate anxiety, foster an unhealthy relationship with food and body image, and reinforce obsessive thoughts about weight and appearance. Healthcare providers should monitor weight and nutritional status regularly, but the frequency should be determined based on the individual's specific needs and in a manner that does not worsen their anxiety.
C. Encourage the client to participate in family therapy:
This is the appropriate choice. Family therapy is often a crucial component of the treatment plan for anorexia nervosa. It helps address family dynamics, communication patterns, and any dysfunctional relationships that might contribute to the eating disorder. Family therapy provides a supportive environment for both the individual with anorexia and their family members, aiding in understanding, coping, and healing.
D. Set a weight gain goal of 2.2 kg (4.9 lb) per week:
Setting specific weight gain goals can be counterproductive and potentially harmful for individuals with anorexia nervosa. Rapid or arbitrary weight gain goals may lead to unhealthy eating behaviors, excessive exercise, or other dangerous practices in an attempt to meet the goal quickly. Instead, healthcare providers focus on a more individualized and gradual approach to weight restoration, ensuring that it is safe, sustainable, and in line with the client's overall health and well-being.
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