For which of the following adverse effects should a nurse monitor a client taking citalopram?

Choice A reason:
Monitoring the client for splitting behaviors is important in managing paranoid personality disorder. Splitting is a defense mechanism where individuals cannot see others as having both positive and negative qualities; they are viewed as either all good or all bad. This behavior can disrupt therapeutic relationships and the treatment process. However, it is not the most constructive action to include in the plan of care.

Choice B reason:
Isolating the client from social or group interactions is not a therapeutic intervention and can be detrimental to the client's mental health. Social interactions can be challenging for individuals with paranoid personality disorder, but complete isolation is not recommended. Instead, the nurse should facilitate appropriate social interactions that do not overwhelm or trigger the client's paranoia.

Choice C reason:
Providing written information about the client's treatment plan can be very beneficial for individuals with paranoid personality disorder. It allows them to review the plan at their own pace and may help reduce feelings of suspicion or paranoia, as they have clear, documented information about their care.

Choice D reason:
Encouraging countertransference is not an appropriate action. Countertransference occurs when a healthcare provider transfers emotions to a client, often based on the provider's past experiences. This can interfere with objective care and is something to be aware of and managed, not encouraged.

Choice A reason:
Telling a client to focus on themselves for a change may come across as dismissive and does not address the underlying feelings of hopelessness. It is important for the nurse to acknowledge the client's feelings and provide support rather than suggesting a shift in focus without understanding the root cause of their distress.

Choice B reason:
Asking the client why they feel like things will never work out can be a useful way to explore their thoughts and feelings. However, it may not be the most immediate concern if the client is experiencing severe hopelessness or suicidal ideation. The nurse should prioritize assessing the client's safety and risk of self-harm.

Choice C reason:
Asking if the client has been thinking about harming themselves is crucial in assessing their safety. Suicidal ideation is a serious concern, and it is important for the nurse to directly address this issue to determine if the client is at risk of self-harm. This response shows that the nurse is taking the client's feelings seriously and is concerned about their well-being.

Choice D reason:
Suggesting an antidepressant might make the client feel better can be helpful in the long term, but it does not address the immediate emotional distress the client is experiencing. Medication can be part of a treatment plan, but the nurse should first ensure the client's immediate safety and provide emotional support.