A nurse is assessing a client with obsessive-compulsive disorder (OCD) The client reports that they have been having recurrent thoughts about contamination. Which of the following is the most appropriate nursing diagnosis for this client?
A.
Impaired social interaction.
B.
Anxiety.
C.
Risk for self-harm.
D.
Obsessive-compulsive disorder.
The Correct Answer and Explanation is:
Correct Answer: B. Anxiety
Explanation:
Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that the individual feels driven to perform. In the scenario provided, the client reports recurrent thoughts about contamination, which is a common obsession in OCD. The most appropriate nursing diagnosis for this client is Anxiety.
Understanding OCD and Anxiety:
OCD is often associated with high levels of anxiety. Obsessions, such as the fear of contamination, cause significant distress and anxiety. To alleviate this anxiety, individuals with OCD engage in compulsive behaviors, such as excessive washing or cleaning, which they believe will prevent the feared outcome (e.g., getting sick from germs). However, these compulsions provide only temporary relief, and the anxiety typically returns, perpetuating a cycle of obsessive thoughts and compulsive actions.
Why “Anxiety” is the Correct Nursing Diagnosis:
- Symptom Correlation: The client’s report of recurrent thoughts about contamination directly links to anxiety. These thoughts are distressing and create a sense of fear or dread, which is a hallmark of anxiety disorders.
- Focus on Client’s Experience: The primary issue for the client is not the obsessive thoughts themselves but the anxiety these thoughts produce. Addressing the anxiety can help in managing the overall symptoms of OCD.
- Nursing Interventions: Interventions for anxiety in clients with OCD might include cognitive-behavioral therapy (CBT), specifically exposure and response prevention (ERP), which helps reduce anxiety by gradually exposing the client to the feared situation without allowing them to perform the compulsive behavior. Nurses can also provide support by teaching relaxation techniques, encouraging the client to verbalize their fears, and promoting coping strategies to manage anxiety.
Why Other Options are Less Appropriate:
- A. Impaired Social Interaction: While clients with OCD may experience social difficulties due to their behaviors, the primary issue in this scenario is the anxiety caused by obsessive thoughts, not social interaction.
- C. Risk for Self-Harm: This would be appropriate if the client exhibited signs of self-harm or expressed suicidal ideation, but the scenario does not indicate such risks.
- D. Obsessive-Compulsive Disorder: This is not a nursing diagnosis but rather a medical diagnosis. Nursing diagnoses focus on the client’s response to health conditions and life processes, such as anxiety in response to OCD.
In conclusion, “Anxiety” is the most appropriate nursing diagnosis for a client with OCD experiencing recurrent thoughts about contamination, as it addresses the underlying issue of distress and fear that drives the compulsive behaviors.