Psychiatric Medications Q 23
When developing a plan of care for a female client with acute stress disorder who lost her sister in a car accident. Which of the following would the nurse expect to initiate?
A. Facilitating progressive review of the accident and its consequences.
B. Postponing discussion of the accident until the client brings it up.
C. Telling the client to avoid details of the accident.
D. Helping the client to evaluate her sister’s behavior.
Correct Answer: A. Facilitating progressive review of the accident and its consequences
The nurse would facilitate progressive review of the accident and its consequence to help the client integrate feelings & memories and to begin the grieving process. Help patients reframe any destructive cognitions (eg, beliefs that they acted terribly and are terrible people or are weak for being so distraught, that life is hopeless or worthless, or that the world is totally unsafe).
Option B: Support self-esteem; help patients understand that their reaction to the trauma is a normal reaction to an abnormal situation, not a sign of weakness or psychopathology. Reassure and help survivors concerning immediate needs, such as rest, food, shelter, social support, or a sense of belonging to a community (some feel cut off and detached).
Option C: Promote coping mechanisms. Avoid prompting discussion of issues that cannot be resolved; avoid abreaction in groups and the resulting contagion effect; respect defenses, and do not force reality on people who cannot handle it yet; keep in mind that debriefing may be harmful. Discuss the experience with patients who want to talk about it, and avoid pressuring those who do not wish to discuss it.
Option D: Check to see if children feel that they somehow caused the death or disaster or if they have other misunderstandings, and take pains to reassure them or correct any misunderstanding; do not assume children are fine just because they are not saying anything. Let them know it is all right to talk about unpleasant feelings (including sadness and anger) and listen to them; sharing personal feelings of sadness with them is all right as well.