A client with schizophrenia is hospitalized. After 2 weeks of treatment, the frequency of the client's hallucinations seems to be diminishing. When first hospitalized, the client refused to leave the room. Now the client spends time in the dayroom, sitting in a corner watching television, but does not initiate conversation or social interaction with other clients or staff. What is the most appropriate activity for the client?

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Clients with schizophrenia have difficulty initiating and maintaining social interactions with other people. The nurse can facilitate interpersonal functioning by providing one-on-one interaction in which the client can practice basic social skills in a non-threatening way. Once the client feels more comfortable, the nurse can encourage participation in activities that require some interaction with others. Impaired social interaction is one of the negative symptoms of schizophrenia; others include the following: Inappropriate, flat, or bland affect, and apathy Emotional ambivalence, disheveled appearance Inability to establish and move toward goal accomplishment Lack of energy, pacing and rocking, odd posturing Regressive behavior, inability to experience pleasure Seeming lack of interest in the world and people It is the negative symptoms of schizophrenia that affect a client's ability to establish personal relationships and manage day-to-day social interactions. The positive symptoms of schizophrenia (hallucinations, delusions, thought impairment) often improve with psychotropic medications; negative symptoms tend to persist even with medication. Psychosocial and supportive treatment, including psychotherapy, education, behavioral training, cognitive therapy, and social skills therapy, may be beneficial in improving the quality of life for clients with schizophrenia. (Option B) The client may not be ready for a group activity. However, due to the limited nature of interaction in a group songfest, it would be appropriate when the client is feeling more comfortable being closer to other people. (Option C) The client is not ready for this activity. (Option D) This activity requires interaction with others; the client is not ready for this type of activity. Educational objective: Negative symptoms of schizophrenia include impaired interpersonal functioning and social isolation. Practicing basic social skills in a safe and non-threatening manner, such as a one-on-one activity with the nurse, can help the client with schizophrenia be comfortable with social interactions with others

A Client with Schizophrenia Is Hospitalized