Page 2287 - Saunders Comprehensive Review For NCLEX-RN

▪ Reassure the client that the environment is safe.

▪ Remove the client from group situations if the client’s behavior is too bizarre,
disturbing, or dangerous to others.
▪ Set realistic goals.

▪ Initially, do not offer choices to the client; then gradually assist the client in
making her or his own decisions.
▪ Decrease excessive stimuli in the environment.

▪ Monitor for suicide risk.
▪ Assist the client to use alternative means to express feelings, such as through
music, art therapy, or writing.

Box 65-15

Interventions for Paranoia

▪ Provide a safe environment.
▪ Assure the client that she or he will be safe.
▪ Assess for suicide risk.

▪ Diminish suspicious behavior, such as whispering.
▪ Remain calm, nonthreatening, and nonjudgmental.
▪ Engage the client during brief but frequent interactions.
▪ Establish a trusting relationship.
▪ Maintain physical boundaries and avoid crowding the client.
▪ Promote increased self-esteem.
▪ Respond honestly to the client.
▪ Follow through on commitments made to the client.
▪ Acknowledge the client’s feelings, but tell the client that you do not share her or
his interpretation of an event.
▪ Provide a daily schedule of activities.
▪ Assist the client to identify diversionary activities.
▪ Gradually introduce the client to groups.
▪ Refocus conversation to reality-based topics.
▪ Use role playing to help the client identify thoughts and feelings.

▪ Provide positive reinforcement for successes.
▪ Do not argue with delusions.
▪ Do not whisper in the client’s presence.
▪ Provide the client with the opportunity to complete small tasks.
▪ Monitor eating, drinking, sleeping, and elimination patterns.
▪ Monitor for agitation, and decrease stimuli as needed.

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