Hallucination

Definition

Hallucinations are false sensory perceptions that occur without an external stimulus. They may be auditory, visual, tactile, olfactory, or gustatory and differ from illusions (misinterpretation of real stimuli).

Common Causes

• Schizophrenia (auditory is most common)
• Delirium and severe infection
• Substance intoxication or withdrawal (DTs)
• Dementia (especially Lewy body)
• Brain tumors, lesions
• Medication side effects

Therapeutic Communication

Acknowledge the patient's experience without agreeing: 'I understand that you hear voices, but I don't hear anything.' Redirect to reality. Assess for command hallucinations (especially those directing self-harm or harm to others). Safety priority. Avoid arguing or confirming the hallucination.

Nursing Interventions

Ensure safety, reduce stimuli, administer antipsychotics as ordered (risperidone, olanzapine, haloperidol), and promote medication adherence. Monitor for EPS and metabolic side effects.

NCLEX Relevance

Command hallucinations = immediate safety assessment.