The nurse is interviewing a client with schizophrenia. Which client behavior requires immediate intervention?

Pressure injuries: These can indicate neglect or inadequate care, as they often develop from prolonged periods of immobility or poor hygiene.

Poor hygiene: A foul odor and unclean environment, along with a lack of clothing, can be signs of neglect or mistreatment.

Malnutrition: The client's low weight (98 lb or 44.5 kg) and a lack of appropriate nutrition could indicate inadequate care and potential mistreatment, contributing to overall poor health and well-being.

The client has a history of chronic obstructive pulmonary disease (COPD) and is experiencing episodes of more forceful coughing. This history increases the risk of aspiration, especially when taking oral medications. Aspiration can occur if the medication is not swallowed properly, leading to potential respiratory complications.

Assess swallowing ability: Given the client’s COPD and increased coughing, assessing the swallowing ability is crucial before administering oral medications to ensure that the client can safely swallow the medication and reduce the risk of aspiration.

Place in Fowler’s position: Placing the client in Fowler’s position (or semi-Fowler's position) promotes proper swallowing and decreases the risk of aspiration. It also helps improve respiratory function and comfort in clients with COPD.

Increased coughing or choking after administration: Monitoring for increased coughing or choking after taking the medication can help identify early signs of aspiration and allow for prompt intervention to prevent respiratory complications.

Level of consciousness: Monitoring the level of consciousness is important as changes in consciousness can affect the client’s ability to swallow properly and increase the risk of aspiration. It helps ensure the client remains alert and responsive.