Obsessive-Compulsive Disorder

Repeated handwashing is not the defining clue by itself. The nurse listens for the sequence: an unwanted intrusion or feared consequence, rising distress, and a behavior or mental act intended to neutralize it. The patient may know the ritual is excessive, may be uncertain about it, or may have little insight; insight level changes assessment and treatment planning, not whether symptoms deserve attention. The exam focus is to distinguish OCD from psychosis and personality-based perfectionism, identify functional and safety consequences, and support exposure and response prevention without feeding the cycle through reassurance or accommodation. Medication administration and monitoring remain within prescriber orders, facility policy, individual competence, and the applicable state nurse practice act.