A nurse is caring for a client who refuses to attend group therapy. Which of the following statements should the nurse make?

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.

Rationale for correct choices:

• Amnesia: GHB is known to cause memory loss or amnesia, particularly retrograde amnesia, which makes the client unable to recall events that occurred during intoxication. This is a common effect of GHB when it is used as a "date rape drug."
• Nausea and vomiting: GHB can cause gastrointestinal symptoms, including nausea and vomiting. This is a well-known side effect, especially when the drug is ingested in larger quantities or in combination with alcohol.
• Respiratory depression: One of the most concerning effects of GHB is respiratory depression. This can be life-threatening, as GHB has a sedative effect on the central nervous system, potentially leading to slow or shallow breathing and, in extreme cases, respiratory failure.

Rationale for incorrect choices:

• Hyperthermia: GHB typically causes sedation and hypothermia rather than hyperthermia. While stimulant drugs (e.g., methamphetamine) can lead to increased body temperature, GHB is more commonly associated with decreased body temperature.
• Tachycardia: GHB does not typically cause tachycardia. It is more likely to cause bradycardia (slower heart rate) or maintain normal heart rates due to its sedative effects.
• Combativeness: GHB is a sedative and CNS depressant, not a stimulant. Therefore, it is unlikely to cause combativeness, which is more typically associated with stimulant drugs like cocaine or methamphetamine.