A nurse is providing care for a client with obsessive-compulsive disorder (OCD) Which statement by the nurse would be most appropriate in this situation?

Choice C rationale:

Risperidone is an atypical antipsychotic medication that is sometimes used as an augmentation strategy in treating OCD, particularly in cases where there are prominent obsessive-compulsive symptoms that are not well-controlled by other interventions. However, it's important to note that risperidone's use in OCD is off-label, meaning it's not approved by regulatory agencies specifically for OCD treatment.

Choice D rationale:

Selective serotonin reuptake inhibitors (SSRIs) are a cornerstone of pharmacological treatment for OCD. These medications, such as fluoxetine, sertraline, and fluvoxamine, increase the availability of serotonin in the brain and help alleviate obsessive-compulsive symptoms. They have been extensively studied and are considered first-line treatment options.

Choice A rationale:

Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) commonly used to treat depression and anxiety disorders. While it may have some benefit for anxiety symptoms, including those related to OCD, it is not considered a first-line treatment for OCD. SSRIs have shown greater efficacy for OCD management.

Choice B rationale:

Tricyclic antidepressants (TCAs) were among the first medications used to treat OCD. However, their side effect profiles and the availability of more effective and better-tolerated options, such as SSRIs, have led to TCAs being used less frequently for OCD treatment.

Choice E rationale:

Dopamine agonists are not commonly used for OCD treatment. In fact, they can potentially exacerbate symptoms, as imbalances in dopamine transmission are implicated in the pathophysiology of OCD. Using dopamine agonists without a clear rationale could worsen the condition.

Choice A rationale:

Teach the client relaxation techniques. While teaching relaxation techniques can be beneficial, it may not directly address the client's compulsion to wash their hands repeatedly. OCD involves managing distressing thoughts and compulsions through specific interventions.

Choice B rationale:

Encourage the client to talk about their thoughts and feelings. While promoting open communication is generally important, it may not be the most effective intervention for directly addressing the client's compulsion to wash their hands. OCD interventions often involve exposure and response prevention strategies.

Choice C rationale:

Assist the client in developing a hierarchy of feared situations. This is the correct answer. Helping the client develop a hierarchy of feared situations is a key intervention in addressing OCD. This approach is part of exposure and response prevention therapy, where clients gradually face their fears without engaging in compulsive behaviors.

Choice D rationale:

Praise the client for decreasing the frequency of handwashing. While positive reinforcement can be useful, it may not be the priority intervention for someone with OCD. The focus should be on structured interventions that challenge and reduce the compulsive behaviors over time.