Personality and Mood Disorders Q 42
Situation: A young woman is brought to the emergency room appearing depressed. The nurse learned that her child died a year ago due to an accident. The initial nursing diagnosis is dysfunctional grieving. The statement of the woman that supports this diagnosis is:
A. “I feel envious of mothers who have toddlers”
B. “I haven’t been able to open the door and go into my baby’s room “
C. “I watch other toddlers and think about their play activities and I cry.”
D. “I often find myself thinking of how I could have prevented the death."
Correct Answer: B. “I haven’t been able to open the door and go into my baby’s room.”
This indicates denial. This defense is adaptive as an initial reaction to loss but extended, unsuccessful use of denial is dysfunctional. Allow the patient to recognize and express feelings and determine the connection between the feelings and the event. Expressing feelings in a non-threatening environment can aid patients in handling unresolved issues that may be partly responsible for the depression. It can also aid the patient to relate the feeling to the event.
Option A: This indicates acknowledgment of the loss. Expressing feelings openly is acceptable. Suggest alternative methods to determine and cope with underlying feelings of anger, hurt, and rejection. Allows individuals to explore more ways of handling such situations.
Option C: This indicates the stage of depression in the grieving process. Discuss and educate the patient on the normal stages of grief and accept the reality of related feelings such as guilt, anger, and powerlessness. This allows the patient to acknowledge these normal feelings and remove some of the guilt caused by these feelings.
Option D: Remembering both positive and negative aspects of the deceased love one signals successful mourning. Assist the patient in recognizing early signs of depression and identify methods to mitigate these signs. If the symptoms persist or worsen, suggest other professional support.