A client with obsessive-compulsive disorder washes the hands multiple times daily and is late for meals and milieu activities. Which of the following is most appropriate for the nurse to do initially?
1. Totally eliminate the client’s ritual.
2. Allow the client to decide whether to attend meals and activities.
3. Inform the client that absence from meals and activities is not permitted.
4. Remind the client about meal and activity times so that the ritual can be completed on time.
The nurse should remind the client about meal and activity times so that the ritual can be completed beforehand and not interfere with meals and activities. The client must be allowed to complete the ritual because it keeps anxiety in check. Totally eliminating the client’s ritual will increase anxiety and the need for the hand washing. Allowing the client to decide to attend meals and activities is not appropriate or in the client’s best interest because the client must perform the ritual to assuage anxiety. Informing the client that absence from meals and activities is not permitted scolds the client, increasing anxiety and the need for the ritual.
CN: Psychosocial adaptation; CL: Synthesize