[Verified Answer]: Gerald is a 41 year old male admitted to an…

Gerald is a 41 year old male admitted to an in-patient hospital psychiatric unit. Chart Data: Social History: Born in Canada, Phillipino (Pacific Islander) descent Married x 17 years, 2 children in elementary school Certified Accountant, primary income-earner for the family Fired from his accounting job at a corporation 6 months ago, currently working as a book keeper at a private school Wife works in retail Medical History: Obsessive Compulsive Disorder diagnosed 1 year ago No known allergies No medications Was attending out-patient psychotherapy, however he stopped because it was too expensive 1) Gerald was brought to the Emergency Department by his wife Melissa who is concerned about his behaviour. The nurse learns that Gerald: spends 12-13 hours at work each day repeats the same work tasks over and over to ‘ensure it is perfect’ has difficulty concentrating is easily overwhelmed and becomes angry and violent if things are out of place at work or at home follows a strict daily routine that includes showering 3-4 times per day and eating only white coloured foods RECOGNIZE CUES: Based on Gerald’s story, what should the nurse ask about? Question 15 options: Visual hallucinations Obsessive thoughts Orientation impairment Mood changes Question 16 (1 point) 2) Gerald begins complaining that he absolutely has to shower since it has been over 12 hours since his last shower. He is also close to panicking, stating he needs to re-do his work report because the “title may not be centred and the margins may not be symmetrical”. ANALYZE CUES: What do Gerald’s behaviours suggest he is worried about? Select 2. Select 2 correct answer(s) Question 16 options: Contamination Unacceptable Thoughts Organization, Symmetry & Arranging Confined spaces Doubt, Harm, Safety Question 17 (1 point) 3) A physician suggests that Gerald may have Obsessive Compulsive Disorder, and would benefit from in-patient treatment. PRIORITIZE HYPOTHESES: What priority nursing diagnosis should the nurse focus their care on at this time? Question 17 options: Situational low self-esteem Anxiety Impaired mood regulation Impaired comfort Question 18 (1 point) 4) GENERATE SOLUTIONS. What non-pharmacological treatment would most likely be recommended for Gerald over the long-term? Question 18 options: Avoidance Therapy Cognitive Behaviour Therapy (CBT) Sensory Deprivation Submissive Therapy Question 19 (1 point) 5) While Gerald is an in-patient the nurse aims to reduce potential harm associated with his repeated, compulsive behaviours. ACTIONS: How might the nurse do this? Question 19 options: Encourage Gerald to shower only 1x per week during his stay. Encourage Gerald to use extremely hot water when showering for disinfection. Encourage Gerald to keep his clothes on when showering. Encourage Gerald to use mild, moisturizing soap when showering rather than harsh, abrasive soaps Question 20 (1 point) 6) Gerald’s wife brings a copy of his latest work report to Gerald at the hospital. Together, the nurse and Gerald create a plan for revising his work. GENERATE SOLUTIONS: What strategy could help Gerald cope with his perfectionism and repeated behaviours related to work? Question 20 options: Submit the first draft of the report without any revisions Create a schedule and set time limits to work on the report Revise as many times as necessary until the report appears perfect Seek out a job that is not performance based Question 21 (1 point) 7) EVALUATE. What outcome would indicate that Gerald’s symptoms are improving? Question 21 options: Gerald’s level of interaction with other patients and staff has decreased to only 1x per day within 14 days. Gerald has reduced his showering from 3x to 2x per day for 15 minutes each time. Gerald does not discuss his work or any work-related concerns when questioned in 3 days. Gerald’s score on the GAD-7 remains the same in 7 days.