Mental Health Nursing
A nurse is interviewing a client with schizophrenia when the client begins to say, 'Kite, night, right…
A nurse is interviewing a client with schizophrenia when the client begins to say, 'Kite, night, right, height, fright.' The nurse documents this as:
Explanation
Core Concept: Clang association is a thought disorder characterized by the chaining of words together based on their sound (e.g., rhyming or alliteration) rather than their logical meaning. It is a classic symptom of schizophrenia and manic episodes.
Clinical Presentation:
- Speech that sounds like nonsense rhymes (e.g., "Kite, night, right").
Diagnosis:
- *First-line:* Clinical psychiatric evaluation.
- *Gold Standard:* Longitudinal observation meeting DSM-5 criteria for schizophrenia.
Management:
- *Acute:* Document the speech pattern as *clang association*. Do not argue with the patient or pretend to understand the nonsensical speech. Focus on the underlying feelings or redirect gently.
- *Definitive:* Administer antipsychotic medications to manage positive symptoms of schizophrenia and provide a structured, low-stimulus environment.