A patient with severe schizophrenia is seen at a community mental health center. Although he continues to attend programming at the center, he tells the nurse, "I threw away the pills because they keep me from hearing God."
Which of the following responses would be most likely to benefit this patient? a. "You need your medicines; your schizophrenia will get worse without them.".
b. "Do you want to end up in the hospital again? You have to take your medicines.".
c. "I noticed that with the medicine, you have been able to hold a job you wanted.".
d. "I would like you to come to the medication education group each Thursday.".
C
The patient appears not to understand that he has an illness. He has stopped his medication because it interferes with a symptom that he finds desirable (auditory hallucinations—the voice of God). Connecting medication adherence to one of the patient's goals (the job) can serve to motivate the patient to take the medication and override his concern about losing the hallucinations. Exhorting a patient with anosognosia to take his medication because the medicine is needed to control his illness is unlikely to be successful, because he does not believe he has an illness. Medication psychoeducation would be appropriate if the cause of nonadherence was a knowledge deficit, but here it is anosognosia.
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An ongoing illness that is slow or gradual in onset and for which there is no known cure is:
a. An acute illness b. A chronic illness c. A terminal illness d. A physical illness
The nurse is caring for a 62-year-old patient who is receiving IV gentamicin (Garamycin). The patient complains of difficulty hearing. What should the nurse do?
A) Hold the dose and notify the physician immediately. B) Administer the dose and speak in a louder voice when talking to the patient. C) Administer the dose and report this information to the oncoming nurse. D) Administer the dose and document the finding in the nurse's notes.