A nurse is performing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse identify as a negative symptom?

A. Assist the client to the correct room: This option addresses the immediate safety concern by guiding the client back to their own room, reducing distress for both the client and the other resident. It promotes dignity and minimizes the risk of agitation or further disruptive behavior.

B. Place the client in restraints: Restraints should only be used as a last resort for safety when all other measures have been exhausted and when there's an immediate risk of harm to the client or others. Restraints can be physically and psychologically harmful to individuals with Alzheimer's disease and should not be used unless absolutely necessary.

C. Reorient the client to time and place: Reorientation may not be effective for clients with advanced Alzheimer's disease, as their cognitive impairments may limit their ability to understand or retain this information. Additionally, reorientation may not address the immediate safety concern posed by the client's behavior.

D. Move the client to a room at the end of the hall: While this option may be considered in some situations to minimize disruption to other residents, it does not address the underlying issue of the client's confusion or wandering behavior. Additionally, moving the client may cause further distress and confusion.

C. Dialectical behavior therapy (DBT):

Rationale: This is the correct intervention. Dialectical behavior therapy (DBT) is a type of psychotherapy that is specifically designed to treat borderline personality disorder (BPD). It focuses on teaching clients skills to manage their emotions, improve relationships, and cope with distressing situations effectively. Including DBT in the discharge plan for a client with BPD can help them continue their therapeutic progress after leaving the hospital or clinical setting.

Incorrect:

A. Safety plan:

Rationale: While a safety plan may be appropriate for some clients with borderline personality disorder, it is not specific to DBT and may not address the broader range of issues that DBT aims to target. Safety plans typically focus on identifying triggers for self-harm or suicidal ideation and outlining steps for managing crises, whereas DBT encompasses a more comprehensive approach to managing emotions and behaviors.

B. Behavioral contract:

Rationale: Behavioral contracts are agreements between individuals and their treatment providers that outline specific behaviors, consequences, and rewards. While behavioral contracts may be used as part of a comprehensive treatment plan for clients with BPD, they do not specifically address the skills-based approach of DBT.

D. Bibliotherapy:

Rationale: Bibliotherapy involves the use of written materials, such as self-help books or educational resources, to support therapeutic goals. While reading materials may complement DBT and other therapeutic approaches, bibliotherapy alone is not considered a primary intervention for treating borderline personality disorder.