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Impending coma.
Manipulating behavior
Suppression
Perceptual disorders
Alcohol withdrawal
Cannibis withdrawal
Cocaine withdrawal
Opioid withdrawal
Teach the client about nutrition, calories, and a balanced diet.
Establish a trusting relationship with the client.
Discuss cultural stereotypes regarding thinness and attractiveness.
Explore the reasons why the client doesn't eat.
Tension and irritability.
Slow pulse.
Hypotension
Constipation.
Lithium (Lithobid) and divalproex (Depakote).
Verapamil (Calan) and chlorpromazine (Thorazine)
Alprazolam (Xanax) and phenobarbital (Luminal)
Clozapine (Clozaril) and amitriptyline (Elavil)
Adolescents, men over age 45, and persons who have made previous suicide attempts
Teachers, divorced persons, and substance abusers
Alcohol abusers, widows, and young married men
Depressed persons, physicians, and persons living in rural areas
Echolalia
Palilalia
Apraxia
Aphonia
Unpredictable behavior and intense interpersonal relationships.
Inability to function as a responsible parent.
Somatic symptoms.
Coldness, detachment, and lack of tender feelings.
Extreme social impairment
Suspicious delusions
Waxy flexibility
Elevated affect
Administer the haloperidol orally if the client agrees to take it.
Call the physician to clarify whether the haloperidol should be given orally or I.M
Call the physician to clarify the order because the dosage is too high.
Withhold haloperidol because it may worsen hallucinations.
Reassure the client and administer as needed lorazepam (Ativan) I.M.
Administer as needed dose of benztropine (Cogentin) I.M. as ordered
Administer as needed dose of benztropine (Cogentin) by mouth as ordered
Administer as needed dose of haloperidol (Haldol) by mouth
Take the client's vital signs.
Explore the content of the hallucinations
Tell him his fear is unrealistic
Engage the client in reality-oriented activities
Perphenazine (Trilafon)
Doxepin (Sinequan)
Amantadine (Symmetrel)
Clorazepate (Tranxene)
Take an as-needed dose of psychotropic medication whenever they hear voices.
Practice saying "Go away" or "Stop" when they hear voices.
Sing loudly to drown out the voices and provide a distraction.
Go to their room until the voices go away.
Diazepam (Valium)
Haloperidol (Haldol)
Amitriptyline (Elavil)
Clonazepam (Klonopin)
"I'm a nurse. I'm not poisoning you. It's against the nursing code of ethics."
"I'm a nurse, and you're a client in the hospital. I'm not going to harm you."
"I'm not poisoning you. And how could I possibly steal your soul?"
"I sense anger. Are you feeling angry today?"
"I think you're wrong. France is a friendly country and an ally of the United States. Their government wouldn't try to kill you."
"I find it hard to believe that a foreign government or anyone else is trying to hurt you. You must feel frightened by this."
"You're wrong. Nobody is trying to kill you."
"A foreign government is trying to kill you? Please tell me more about it."
Seizures
Shivering
Anxiety
Chest pain
Avoid shopping for large amounts of food.
Control eating impulses.
Identify anxiety-causing situations.
Eat only three meals per day.
Check the client frequently at irregular intervals throughout the night
Assure the client that the nurse will hold in confidence anything the client says
Repeatedly discuss previous suicide attempts with the client
Disregard decreased communication by the client because this is common in suicidal clients
Deferoxamine mesylate (Desferal)
Succimer (Chemet)
Flumazenil (Romazicon)
Acetylcysteine (Mucomyst)
Naloxone (Narcan)
Haloperidol (Haldol)
Magnesium sulfate
Chlordiazepoxide (Librium)
"I trust you not to purge."
"How are you purging and when do you do it?"
"Don't worry. I won't allow you to purge today."
"I know it's important for you to feel in control, but I'll monitor you for 90 minutes after you eat."
"If you continue to talk like that, I'm going to stop speaking to you."
"You told me you got fired from your last job for missing too many days after taking drugs all night."
"Tell me more about how it felt to get high."
"Don't you know it's illegal to use drugs?"
The client will establish adequate daily nutritional intake
The client will make a contract with the nurse that sets a target weight
The client will identify self-perceptions about body size as unrealistic
The client will verbalize the possible physiological consequences of self-starvation