Final answer:
The most therapeutic nursing intervention for a client with OCD and a ritualistic handwashing routine is to implement gradual exposure and response prevention therapy while providing a supportive environment to help reduce the compulsion.
Step-by-step explanation:
A client diagnosed with obsessive-compulsive disorder (OCD) who is frequently late for appointments due to an extensive handwashing routine is exhibiting impaired social skills, repetitive motor behaviors, and strict adherence to rituals, all common in OCD. A therapeutic nursing intervention would consist of acknowledging the significance of the handwashing ritual while gradually helping the client to reduce the behavior. This could involve cognitive-behavioral therapy (CBT), specifically exposure and response prevention (ERP), which encourages the client to gradually face the obsessions without performing the compulsive behavior.
This approach should be done cautiously and professionally, considering the individual's readiness for change. It is essential to maintain a supportive and nonjudgmental environment, providing reassurance and encouragement. Ultimately, the goal is to help the client reduce the time spent on the ritual without experiencing significant distress, thereby improving punctuality and overall functioning.