Question

Tiffany, a teenager with obsessive-compulsive disorder, washes her hands until they are cracked and bleeding. Your nursing goal is to promote healing of her hands. What interventions will you plan?

Answer 1

Obsessive Compulsive Disorder (OCD) is an anxiety disorder characterised by uncontrollable, unwanted thoughts and ritualized repetitive behaviours one feel compelled to perform. People with contamination fears will typically engage in excessive washing inorder to remove dirt and germs or just to feel clean.

The nursing interventions of client with cracked hands to promote healing are as follows

• Assist client to recognize the onset of anxiety.
• Explore the meaning and purpose of behaviour with the client.
• Interrupt the client's hand washing ritual and tell her it is not necessary for her to wash her hands so many times.
• Once hands are clean , ask her to carefully turn off the tap with another object such as towel or napkin to avoid the fear of contamination.
• Effective nursing interventions include therapeutic communication, teaching relaxation and behaviour techniques, and client and family education about OCD and its treatment.
• The aim of dermatological treatment is to protect and manage the damaged skin using barrier creams, emolients such as applying petroleum jelly, short course ( 2-4 weeks) of topical steroids.
• Advice the client to apply emolients in hands before going to sleep to prevent dryness of hands.
• Provide extra moisturizing hand wash solution to the client.