Obsessive-Compulsive Disorder (11 Questions)

1. Mme Tremblay, 34 years old, is admitted to the psychiatric unit for severe OCD. She spends 45 minutes washing her hands every time she touches a doorknob. Upon admission, she is standing at the sink scrubbing her raw, bleeding hands. The admission interview is scheduled for now.

Question:
What is the most appropriate initial nursing approach? *
2. M. Gagnon, 22 years old, has a compulsion involving washing his hands with harsh bleach and scrubbing brushes. His hands are cracked, oozing, and showing signs of infection.

Medical Order: Apply moisturizing cream BID. Fluoxetine 20 mg PO daily.

Question:
While working on reducing the frequency of the ritual, what is the priority nursing intervention regarding his physical safety? *
3. Mme Roy has a ritual of checking her room 50 times before leaving. This takes her 1 hour. Because of this, she misses breakfast and group therapy every morning, which increases her isolation.

Question:
What is the most effective nursing intervention to ensure she attends therapy? *
4. M. Dubé suffers from intrusive obsessive thoughts about harming his family, which distresses him greatly. He knows these thoughts are irrational but cannot stop them. You are teaching him a cognitive-behavioral technique.

Question:
Which technique is indicated for this symptom? *
5. Mme Lefebvre, admitted for OCD, has lost 5 kg. She refuses to eat hospital food because she believes "the trays are contaminated with deadly bacteria." She is staring at her tray but not eating.

Medical Order: Diet as tolerated.

Question:
What is the best strategy to encourage intake? *
6. M. Fortin has tried several SSRIs with no success. The physician prescribes Clomipramine (Anafranil) 25 mg PO daily. M. Fortin asks why he has to take this new pill.

Question:
What is the specific indication for Clomipramine? *
7. You are a home health nurse visiting Mme Poirier, 70 years old. You cannot enter the living room because it is stacked floor-to-ceiling with old newspapers and magazines. There is only a narrow "goat path" to the kitchen. Mme Poirier becomes extremely agitated when you suggest throwing a paper away.

Question:
What is your priority intervention? *
8. Mlle Caron, 19 years old, is admitted after a suicide attempt. She refuses to leave her room without a heavy veil over her face. She tells you, "My nose is a deformed monster. Everyone stares at it. I need surgery to fix it or I can't live." You observe her nose appears completely normal.

Question:
How do you address her statement? *
9. M. Lambert, 55 years old, started Clomipramine (Anafranil) 4 days ago. He reports to the nurse: "I feel like I have to pee, but I can't get much out." His lower abdomen looks distended.

Question:
What is your interpretation and action? *
10. The husband of Mme Cloutier (who checks the door locks 20 times a night) tells you: "I used to yell at her to stop, but now I just check the locks for her to keep the peace. I check them 20 times so she doesn't have to."

Question:
What is this behavior called, and what is its effect? *
11. M. Boucher, 42 years old, was admitted yesterday for severe Obsessive-Compulsive Disorder. He has a rigid morning ritual involving dressing and undressing in a specific sequence that takes exactly 2 hours to complete. Breakfast is served in the dining room from 08:00 to 08:30. Because he starts his ritual at 07:00, he is not ready until 09:00, missing the meal and the social interaction with other patients. He is becoming distressed about missing food.

Question:
In the initial phase of treatment, what is the most appropriate nursing intervention to ensure his physiological needs are met while addressing the OCD? *