Psychotic Disorders no. 4001

Psychotic Disorders no. 4001

QUESTION: A client with delusional thinking shows a lack of interest in eating at meal times. She states that she is unworthy of eating and that her children will die if she eats. Which nursing action would be most appropriate for this client?

✘O a.) Telling the client that she may become sick and die unless she eats
✘O b.) Paying special attention to the client's rituals and emotions associated with meals
✓O c.) Restricting the client's access to food except at specified meal and snack times
✘O d.) Encouraging the client to express her feelings at meal times

RATIONALE

RATIONALE: Restricting access to food, except at specified times, prevents the client from eating when she feels anxious, guilty, or depressed; this, in turn, decreases the association between these emotions and food. Telling the client she may become sick or die may reinforce her behavior because illness or death may be her goal. Paying special attention to rituals and emotions associated with meals also would reinforce undesirable behavior. Encouraging the client to express feelings at meal times would increase the association between emotions and food; instead, the nurse should encourage her to express feelings at other times.
NURSING PROCESS STEP: Implementation
CLIENT NEEDS CATEGORY: Physiological integrity
CLIENT NEEDS SUBCATEGORY: Basic care and comfort
COGNITIVE LEVEL: Application