A client with obsessive-compulsive disorder (OCD) reports, “Thoughts stick in my mind and the rituals I use are stupid, but I cannot control them. People laugh at me, but they do not understand how awful it is. I am a burden to my family because I cannot hold a job. I do not know how much longer I can live this way.” Which information is most important for the practical nurse (PN) to ask in response to the client’s statements?
A.
Question about which rituals are most often used to reduce anxiety.
B.
Ask if the obsessions and compulsions interfere with sleep.
C.
Inquire if the distress could lead to considering suicide as an option.
D.
Determine what makes the client think people are laughing.
The Correct answer and Explanation is:
The most important information for the practical nurse (PN) to ask in response to the client’s statements is:
C. Inquire if the distress could lead to considering suicide as an option.
Explanation:
When a client with obsessive-compulsive disorder (OCD) expresses feelings of being a burden, experiencing intense distress, and indicating a struggle with daily functioning, it is crucial to assess for potential suicidal ideation. This is especially important given the client’s mention of being unable to control their rituals, feeling like a burden to their family, and expressing hopelessness about their situation.
Why Option C is Most Important:
- Assessment of Suicide Risk:
- The client’s expression of hopelessness and feeling like a burden can be indicative of severe emotional distress. Asking directly about suicidal thoughts is essential for determining the level of risk. Clients with OCD may experience significant distress and frustration, and this distress can sometimes lead to suicidal ideation. Immediate evaluation of suicidal thoughts is crucial for ensuring the client’s safety and planning appropriate interventions.
- Safety Consideration:
- Ensuring the client’s safety is the highest priority. Identifying whether the client is considering suicide allows for timely intervention and support. If the client is at risk, they may need immediate psychiatric evaluation, crisis intervention, or adjustments to their treatment plan to address both their OCD symptoms and any suicidal thoughts.
Other Options Explained:
- Option A: Question about rituals – While understanding the client’s rituals and their impact on anxiety is important for treatment planning, it is not the immediate priority compared to assessing for suicidal thoughts.
- Option B: Sleep interference – This is relevant for understanding the overall impact of OCD on daily functioning but does not directly address the immediate risk of suicide.
- Option D: Perception of being laughed at – Although understanding this perception is important for addressing the client’s self-esteem and social interactions, it does not directly address the immediate risk of self-harm or suicidal ideation.
In summary, addressing potential suicidal ideation is crucial for the client’s immediate safety and wellbeing, making Option C the most important question for the PN to ask.