In caring for a client with paranoid schizophrenia who has weight loss and accuses staff of poisoning, which nursing intervention is a priority to include in the plan of care?

• A. provide the client with pre packaged foods that the client likes
• B. Monitor room for signs of aggression and restrain if necessary
• C. Encourage the client to disclose feelings about poisoning in group therapy
• D. Limit the client’s intake to ensure safety

Answer: (A)

Prioritize safe, adequate nutrition while reducing the patient’s fear of poisoning. Providing pre-packaged foods the patient likes helps in two crucial ways: it limits the risk of tampering with meals since the foods are sealed, and it gives the patient control over what they eat. This approach supports better intake and helps stabilize weight, which is a primary nursing goal when weight loss is present. By choosing familiar, preferred items, the patient is more likely to eat consistently, improving nutritional status and overall stability.

Other options fail to address the immediate need for nutrition and safety in this context. While safety is always important, relying on restraints is not a first-line or therapeutic solution and can escalate fear. Group therapy and discussions about poisoning can be useful later, but they don’t directly resolve the urgent issue of ensuring adequate caloric intake. Limiting intake would worsen weight loss and undermine trust.