Why should the nurse reinforce reality hallucinations

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Why should the nurse “reinforce reality”? Hallucinations represent an alternate reality for the client. Ask the pt “what you do in the ‘leisure activities’ group?”***The nurse will reinforce reality for the patientFYI: illusion- you have something behind it. Eg: there’s a big coat in a dark room Delusions ***Are Delusions and Hallucinations linked in some way? Know the difference FOR THE TEST!!Delusions are fixed beliefs which become an alternate reality for the client.** Delusions can exist without hallucinations. Sometimes there is a casual link.The MOST EFFECTIVE intervention for delusions is: medicationsDelusional people will agree with the nurse about the facts. They just disagree with the interpretation. **The nurse should establish a relationship or milieu that promotes trust.Why do you avoid pointing out what makes the delusions false? Because the need to defend the delusional belief will increase anxiety and make the client elaborate to explain the inconsistency. Do not join the delusion. Schizophrenics lack humor; they will not understand sarcasm or irony.If the nurse reinforces reality, what is REAL that you can talk about?the person’s feelingsobservable factsthe nurse’s personal experience
3How do you know what the patient is feeling?The Nurse will reflect feeling expressed through the delusion. [on an exam, what would this look like?]eg: “it must be frightening to think that the police are after you”The nurse will reinforce reality through statements of accurate fact but will notargue. Change the subject away from the delusions. And always reinforce reality through focusing on the “here and now”, like “what are you planning to have for lunch today”.The nurse may express doubt [on an exam, what would this look like?] don’t let themknow you doubt them bc they will defend. Eg: instead of saying I doubt that these ads from different magazines are actually a secret code, you will say, “I have never heard that ads in magazines could be used as a secret code”.What activity would be best to assign to a person preoccupied with delusional thoughts? Provide a jigsaw puzzle with 200-1000 pieces to put together. No challenging games like checkers and nothing that will reinforce the delusional thought like asking them to write a journal about their feelings and experiences. Schizophrenia & violence:-The probability that a pt experiencing schizophrenia will become violent with the nurse is no more likely that a person without schizophrenia. CATATONIA -An abnormal behavioral response to overwhelming terror-A statue like ability to hold a posture beyond the point when most would feel pain-Sudden, unpredictable frantic activity without apparent goal.** try not to overstimulate themInterventions for Catatonia are based on the rationale that the nurse needs to reduceenvironmental stimuli that increase pt anxiety.

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