PARANOIA 239 26. Review Side Effects of Medications (2 6) A. The possible side effects related t o the client's medications were reviewed with the client. B. The client identified significant side effects, and these were reported to the medical staff. C. Possible side effects of the client's medications were reviewed, but he/she denied experiencing any side effects. D. The client was monitored for signs of tardive dyskinesia. 27. Advocate for Medications to Reduce Side Effects (2 7) A. Advocacy was provided with the client's physician/psychiatrist for an adjustment in his/her medications to reduce or eliminate tardive dyskinesia. B. The client's physician has been able to modify his/her medications in order to maintain efficacy and decrease the likelihood of long-term side effects (e. g., tardive dyskinesia). C. The client's medications cannot be m odified to reduce the likelihood of long-term side effects (e. g., tardive dyskinesia) without reducing efficacy, and this was presented to him/her. D. The client has identified his/her willingness to have reduced efficacy of his/her medications in order t o reduce the likelihood of long-term side effects (e. g., tardive dyskinesia), and this was processed. E. The client has elected to accept the risk for long-term side effects (e. g., tardive dyskinesia) in order to have greater efficacy in his/her medicatio ns, and the risks and benefits of this decision were reviewed. 28. Assess Tardive Symptoms (2 8) A. Arrangements were made for assessment of the client's tardive symptoms, using the client, the staff, or personal observation. B. Objective measurement of the client's tardive symptoms was performed by qualified personnel using a specific instrument (e. g., the Abnormal Involuntary Movement Scale [AIMS]). C. The client displayed no evidence of tardive symptoms, and this was reflected to him/her. D. The clie nt displayed both subjective and objective evidence of tardive symptoms, and this was reported to the physician who prescribed his/her psychotropic medications. 29. Explore Paranoid Thinking (29) A. The client was referred for cognitive-behavioral therapy to explore his/her paranoid thoughts. B. The client was provided with cognitive-behavioral therapy to educate him/her about his/her paranoid thoughts. C. Skills training was provided to the client regarding his/her paranoid thoughts. D. Behavioral expe riments were conducted in order to help the client understand more about his/her paranoid thoughts. E. As a result of the therapy, the client has come to understand more about his/her paranoid thoughts. F. Despite significant therapy to help understand h is/her paranoid thinking, the client does not display any insight in this area. 30. Teach about Cognitive Restructuring and Behavioral Experiments (30) A. The client was taught about how cognitive restructuring can be used to reality test delusional thoughts, decrease fears, develop personal skills, and build confidence. 