A nurse is performing a home visit on a client who has Alzheimer's disease and their partner. The partner states, "I wish I had some time to myself and run errands, but I need to be here all the time." Which of the following referrals should the nurse recommend to the client's partner?

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.

A. "I will learn how to voluntarily control my blood pressure and heart rate": This statement refers to biofeedback, which focuses on controlling physiological responses like heart rate and blood pressure. It is not part of cognitive reframing, which targets thoughts.

B. "I will focus on a mental image while concentrating on my breathing.": This is describing guided imagery and relaxation techniques. While these are effective stress management strategies, they are not part of cognitive reframing, which focuses on altering negative thought patterns.

C. "I will progressively relax each of my muscle groups when feeling stressed.": This statement refers to progressive muscle relaxation, which helps with physical relaxation but does not involve changing thought patterns.

D. "I will practice replacing negative thoughts with positive self-statements": This is an accurate description of cognitive reframing. It involves identifying negative thoughts and replacing them with more balanced or positive ones to manage stress and improve emotional well-being.