Schizophrenia and Client

2908 Words Sep 26th, 2013 12 Pages
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.

Based on this assessment, what is the most important nursing intervention?
A) Establish rapport and trust.
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Which client behavior validates the need for involuntary hospitalization?
C) Violence towards father.
Risk for violence towards self or others are criteria for involuntary hospitalization.
Guarded and suspicious behaviors do not justify involuntary hospitalization.
After 96 hours of involuntary commitment, a client must be asked to sign consent for hospitalization.
If a client who has voluntarily chosen to be hospitalized should want to leave the hospital, which assessment would be most important in deciding to release the client against medical advice (AMA)?
D) Potential danger to self or others.
Potential for harm to self and others is the most important assessment in deciding to release the client AMA.

Adverse Effects

Bob is admitted to the mental health unit for 96 hours. The nurse reviews the routine admission lab and medication prescriptions, and notes that the client will resume the fluphenazine decanoate (Prolixin). The benztropine (Cogentin) has not been prescribed.

Which nursing action is best?
A) Obtain a prescription to begin the Cogentin.
The nurse should request a prescription for Cogentin, which will help prevent the extrapyramidal side effects of the Prolixin, with the exception of tardive dyskinesia. There is a risk of decreased efficiency of Prolixin when the client is also taking Cogentin.
Which side effects would the nurse most likely observe with fluphenazine
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