The nurse working in a free clinic is caring for a homeless client dia

The nurse working in a free clinic is caring for a homeless client diagnosed with paranoid schizo-phrenia who has reported that, “I hurt my foot running away from them. It hurts so bad I can hardly walk now.”

On assessment the nurse notices bruising on the client’s back, arms, and thighs, a red rash on both neck and face, and poor personal hygiene, in addition to edema of the left ankle. The nurse should first realize that this client is at risk for:
1. Physical abuse and assault
2. Drug addiction relating to pain
3. Communicable immune disorders
4. Hospitalization due to mental disorder

ANSWER

ANS: 1
When a client has a severe mental illness such as schizophrenia there are multiple health and so-cioeconomic problems you will need to explore. Many clients with pervasive mental illnesses are homeless or live in poverty. In addition, mentally ill clients are at greater risk of abuse and as-sault. This client’s reported foot injury and observable bruising support the possibility of abuse/assault. While drug abuse may be a consideration, it does not represent the best option of-fered for this item because there is not indication that the client is drug seeking. Contacting communicable diseases is a risk factor for such a client but it does not represent the best option offered for this item because there are several factors that may indicate abuse/assault. Hospitali-zation may be required but it does not represent the best option offered for this item because there is no indication that the client is experiencing a psychiatric crisis.