Schizophrenia and Client
Meet the Client: Bob Tyler
Bob Tyler, a 40-year-old male, is brought to the emergency department by the police after being violent with his father. Bob has multiple past hospitalizations and treatment for schizophrenia. Bob believes that the healthcare providers are FBI agents and his apartment is a site for slave trading. He believes that the FBI has cameras in his apartment to monitor his moves and broadcast them on TV.
Initial Assessment
The nurse asks Mr. Tyler what he would like to be called. He replies, "You've seen me on TV. My name is Bob!" The nurse assesses that Bob's behavior is guarded and suspicious.
1.
Based on this assessment, what is the most important nursing intervention?
A) Establish rapport and trust.
CORRECT
The most important intervention for a client who is suspicious and guarded is to establish rapport and trust. The beginning of trust is more readily established through nonverbal communication when clients have cognitive disorders and difficulty processing language.
2.
What is the most accurate assessment if the client believes that the healthcare providers are FBI agents and there are cameras in his apartment to monitor his moves?
B) Delusions.
CORRECT
Delusions are fixed, false beliefs that the nurse should avoid trying to logically disprove to the client.
The nurse understands that Bob has a thought disorder rather than a mood disorder. Thought disorders include psychosis and schizophrenia.
3.
Which behavior is characteristic of a thought disorder?
C) Disorganized speech.
CORRECT
Disorganized speech is characteristic of thought disorders. It is the manifestation of disorganized thoughts.
Mental Status Exam
The nurse completes the mental status exam and records that Bob's grooming and hygiene are fair. Bob continually paces in the hall and is unable to sit still for longer than 1 or 2 minutes. His speech is rapid and difficult to follow. He describes his mood as "blasé." His affect is anxious and his facial expression is flat with
Bob Tyler, a 40-year-old male, is brought to the emergency department by the police after being violent with his father. Bob has multiple past hospitalizations and treatment for schizophrenia. Bob believes that the healthcare providers are FBI agents and his apartment is a site for slave trading. He believes that the FBI has cameras in his apartment to monitor his moves and broadcast them on TV.
Initial Assessment
The nurse asks Mr. Tyler what he would like to be called. He replies, "You've seen me on TV. My name is Bob!" The nurse assesses that Bob's behavior is guarded and suspicious.
1.
Based on this assessment, what is the most important nursing intervention?
A) Establish rapport and trust.
CORRECT
The most important intervention for a client who is suspicious and guarded is to establish rapport and trust. The beginning of trust is more readily established through nonverbal communication when clients have cognitive disorders and difficulty processing language.
2.
What is the most accurate assessment if the client believes that the healthcare providers are FBI agents and there are cameras in his apartment to monitor his moves?
B) Delusions.
CORRECT
Delusions are fixed, false beliefs that the nurse should avoid trying to logically disprove to the client.
The nurse understands that Bob has a thought disorder rather than a mood disorder. Thought disorders include psychosis and schizophrenia.
3.
Which behavior is characteristic of a thought disorder?
C) Disorganized speech.
CORRECT
Disorganized speech is characteristic of thought disorders. It is the manifestation of disorganized thoughts.
Mental Status Exam
The nurse completes the mental status exam and records that Bob's grooming and hygiene are fair. Bob continually paces in the hall and is unable to sit still for longer than 1 or 2 minutes. His speech is rapid and difficult to follow. He describes his mood as "blasé." His affect is anxious and his facial expression is flat with