Psychotic Disorders: Initial Plan of Care for a Client Who Has Schizophrenia (RN QSEN -

Patient-centered Care, Active Learning Template - System Disorder, RM MH RN 10.0 Chp 15)

 Provide a structured, safe environment (milieu) for the client to decrease anxiety and to

distract the client from constant thinking about hallucinations

 Promote therapeutic communication to lower anxiety, decrease defensive patterns, and

encourage participation in the milieu.

 Program of assertive community treatment (PACT): Intensive case management and

interprofessional team approach to assist clients with community‑living needs.

Depressive Disorders: Priority Findings to Share with Treatment Team (RN QSEN -

Teamwork and Collaboration, Active Learning Template - System Disorder, RM MH RN

10.0 Chp 13)

 Suicide risk: Assess the client’s risk for suicide and implement appropriate safety

precautions.

 Self‑care: Monitor the client’s ability to perform activities of daily living and encourage

independence as much as possible.

 Communication: Make observations rather than asking direct questions, which can

cause anxiety in the client. For example, the nurse might say, “I noticed that you

attended the unit group meeting today,” rather than asking, “Did you enjoy the group

meeting

Legal and Ethical Issues: Right to Refuse Treatment (RN QSEN - Patient-centered Care,

Active Learning Template - Basic Concept, RM MH RN 10.0 Chp 2)

 Freedom from harm related to physical or pharmacological restraint, seclusion, and any

physical or mental abuse or neglect

 A psychiatric advance directive that includes the client’s treatment preferences if an

involuntary admission is necessary

 Provision of care with the least restrictive interventions necessary to meet the client’s

needs without allowing him to be a threat to himself or others

Sexual Assault: Communicating with a Client (RN QSEN - Safety , Active Learning

Template - Basic Concept, RM MH RN 10.0 Chp 33)

 Perform a self‑assessment. It is vital that the nurse who works with the client who has

been sexually assaulted be empathetic, objective, and nonjudgmental. If the nurse feels

emotional about the assault due to some event or person in his own past, it can be