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Zorluk: OrtaMental Health Concepts

A nurse is caring for a client with obsessive-compulsive disorder (OCD) on their first day of inpatient treatment. The client has a complex ritual of tapping the doorframe exactly twelve times before crossing any threshold. As lunchtime approaches, the nurse observes the client beginning this tapping sequence at the entrance to the dining hall. What is the most appropriate nursing action?

  1. Permit the client to finish the tapping sequence before they enter the dining hall.Cevap
  2. B
    Gently interrupt the behavior and logically explain that the tapping is unnecessary.
  3. C
    Physically block the client's access to the doorframe to help stop the compulsion.
  4. D
    Ask the client to analyze why they feel compelled to perform this specific action.

Cevap

The correct action is to permit the client to finish the tapping sequence before they enter the dining hall.
The correct action is to allow the client to complete the ritual. In the initial phase of treatment for a newly admitted client with OCD, compulsions should not be abruptly interrupted. The ritual serves as an essential, albeit maladaptive, coping mechanism to manage severe anxiety. Preventing the compulsion will cause the client's anxiety to escalate to a panic level. Once a therapeutic relationship is established and baseline anxiety is managed pharmacologically, the nurse will collaborate with the client to gradually set limits on the time spent performing rituals.

Adım Adım Çözüm

1
Assess the client's stage of treatment and the purpose of the observed behavior.
The client is newly admitted (initial phase) and performing a compulsion to manage severe internal anxiety.
Understanding that compulsions temporarily relieve extreme anxiety dictates the immediate intervention strategy.
2
Determine the safety and immediate consequences of interrupting the behavior.
Abruptly blocking the compulsion will remove the client's only coping mechanism, leading to an immediate panic attack.
Maintaining client safety and emotional stability is the highest priority on the first day of admission.
3
Select the intervention that maintains safety while establishing trust.
Allowing the ritual to conclude prevents panic and builds the rapport necessary for future therapy.
Limit-setting on rituals is a collaborative process implemented later in the treatment plan, not abruptly on admission.

Anahtar Kavram

Management of Compulsive Behaviors in Early Treatment
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Mental Health Concepts

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