Obsessive-Compulsive Disorder (Sherpath)

The nurse evaluates the plan of care for a patient with OCD. Which statement made by the patient indicates an understanding of the disorder and its treatment?

"I need to work on being more proactive in cooking meals, showering, and going to bed at a decent hour." Patients with OCD are prone to neglecting self-care and should be reminded to take an active role in these tasks.

Which statement made by the nurse to a patient diagnosed with OCD is most therapeutic?

"It is great that you are drawing the connection between your feelings of anxiety and the need to pray every few minutes." It is important that the nurse help the patient connect feelings and behaviors.

Which statement made by the patient diagnosed with OCD demonstrates an understanding of the nurse's teaching about the disorder?

"Playing games and staying busy are good ways for me to cope with my OCD." Playing games and staying busy help patients find positive coping behaviors for their thoughts and actions.

Which statement about trichotillomania is correct?

Anxiety is reduced when the individual experiences pain from hair pulling. The individual experiences relief after the pain associated with hair pulling.

The interdisciplinary health care team is meeting to determine effective strategies in the care of a patient diagnosed with OCD. Which strategy suggested by the nurse is most beneficial for this patient?

Behavior training group The OCD patient does well in group settings that focus on social skills and behavior training to help express feelings.

What evidence suggests that OCD is a neurologically based disorder?

Brain imaging studies showing dysfunction in the basal ganglia In OCD, the frontal lobe and basal ganglia show increased brain activity. Positive response to SSRIs and clomipramine in serotonin regulation SSRIs and clomipramine help balance the serotonin dysregulation found in OCD. Brain imaging studies showing an increase in metabolic activity in the pre-frontal cortex Brain imaging studies of patients with OCD show both an increase in metabolic activity in the pre-frontal cortex and dysfunction in the basal ganglia, which are involved in the development of OCD.

A patient recently diagnosed with OCD has symptoms of increased anxiety. The psychiatric advanced practice registered nurse (APRN) starts the patient on fluoxetine. What other medication would be beneficial for this patient?

Clonazepam Clonazepam is a benzodiazepine used to treat anxiety. While the patient is waiting for the SSRI to reach therapeutic levels, which can take a few weeks, it is beneficial for the patient to be prescribed a benzodiazepine to help control anxiety.

The interdisciplinary health care team is caring for a patient who was diagnosed with OCD over a year ago and who has not responded positively to treatment. Which intervention is most appropriate for this patient?

Deep brain stimulation Deep brain stimulation is an effective treatment for patient with OCD who have not done well with other treatments. It is a surgical intervention that involves placing electrodes in the brain to stimulate electrical activity that decreases OCD symptoms.

Which neurological disorders most commonly accompany OCD?

Epilepsy Epilepsy, due to abnormal electrical activity in the brain, is usually seen in conjunction with OCD. Brain trauma Brain trauma, which can alter brain chemicals, is associated with OCD. Huntington's disease Huntington's disease, which results in death of brain cells, is commonly linked to OCD.

The nurse assesses a patient recently diagnosed with OCD. Which assessment finding requires immediate intervention by the nurse?

Excessive unresolved anxiety Excessive anxiety levels can cause the OCD patient to become reckless and attempt suicide. Maintaining patient safety is the priority nursing intervention.

Which are types of obsessions associated with OCD?

Harm Patients with OCD are typically obsessed with harm, which is why they continuously make sure the door is locked or oven is off multiple times. Religious concerns Patients with OCD are typically preoccupied with religious concerns. Unwanted sexual thoughts Unwanted sexual thoughts can lead the patient to participate in OCD behaviors.

Which statement regarding obsession is true?

Obsession is characterized by persistent thoughts. Obsession is characterized by persistent thoughts, urges, or images that cause marked anxiety.

Why should the nurse set limits on ritualistic behaviors but not totally take rituals away?

Panic Patients who have had their ritualistic behaviors taken away can experience panic that can lead to self-harm in an attempt to alleviate the panic.

The nurse develops a care plan for a patient diagnosed with OCD. Which patient outcome best demonstrates the patient's adherence to the treatment plan?

Patient goes to the gym three times a week. Going to the gym three times a week demonstrates the patient's commitment to wellness. Exercise decreases the symptoms of anxiety associated with OCD.

Which is a common side effect of selective serotonin reuptake inhibitors (SSRIs) used in the treatment of OCD?

Sexual dysfunction Sexual dysfunction is a common side effect of SSRIs used in the treatment of OCD.

Which feelings are children with OCD most likely to experience?

Shame Children with OCD often feel shame and helplessness because their rituals hinder forming relationships with others. Exclusion Children with OCD often feel excluded because of their inability to form relationships with peers. These children may also be ridiculed by their peers which leads to further feelings of exclusion. Loneliness Children with OCD often experience loneliness because their rituals take a majority of their time, which does not leave substantial time to spend with others.

The nurse is caring for a patient diagnosed with OCD. The patient tells the nurse that her anxiety has decreased, but she still spends a great deal of time at home organizing her belongings. Which nursing diagnosis is most appropriate for this patient?

Social isolation If the patient is spending an excessive amount of time at home, the patient is at risk for social isolation.

A patient with OCD has recently been prescribed an SSRI. Which possible side effect is most important for the interdisciplinary health care team to monitor in this patient?

Suicidal ideation Suicidal ideation may be experienced by patients in the first few weeks of antidepressant therapy. This side effect diminishes with time

Which therapeutic technique implemented by the interdisciplinary health care team is most effective in treating the patient with OCD?

Thought-stopping The patient uses a rubber band along with the word "stop" when an intrusive thought occurs.