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 severe distress, and uncertainty about how much longer they can continue living with their condition, it is crucial to assess for suicidal ideation. This is because individuals with OCD who feel overwhelmed by their symptoms may be at increased risk for suicidal thoughts or behaviors. The client’s statement indicates a significant level of distress and hopelessness, which can be red flags for suicidal ideation.
Here’s a breakdown of why option C is the most critical:
- Assessment of Suicide Risk: The client’s remarks about their inability to control their rituals, feeling like a burden, and expressing uncertainty about their ability to continue living suggest a high level of distress. It is essential to evaluate whether these feelings are accompanied by thoughts of self-harm or suicide. This is a priority because it directly impacts the client’s safety and immediate care needs.
- Immediate Safety Concerns: Inquiring about suicidal thoughts helps to identify if the client is at immediate risk and ensures that appropriate interventions can be initiated to address their safety. If a client is considering suicide, a comprehensive safety plan and possible referral for crisis intervention or higher levels of care may be necessary.
- Understanding the Client’s Distress: While understanding the rituals (option A) and the impact on sleep (option B) are important for managing OCD, addressing suicidal ideation is more urgent in this context because it involves immediate safety concerns. Option D, which involves questioning why the client thinks people are laughing, might be relevant for understanding the client’s social perceptions and self-esteem issues, but it does not address the immediate risk of self-harm or suicide.
In summary, the most crucial aspect to explore in response to the client’s statements is whether the distress from their OCD is leading them to consider suicide, ensuring that their immediate safety is prioritized.