Psychiatric Medications Q 31
After seeking help at an outpatient mental health clinic, Ruby who was raped while walking her dog is diagnosed with posttraumatic stress disorder (PTSD). Three months later, Ruby returns to the clinic, complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate for Ruby?
A. Recommending a high-protein, low-fat diet.
B. Giving sleep medication, as prescribed, to restore a normal sleep-wake cycle.
C. Allowing the client time to heal.
D. Exploring the meaning of the traumatic event with the client.
Correct Answer: D. Exploring the meaning of the traumatic event with the client.
The client with PTSD needs encouragement to examine and understand the meaning of the traumatic event and consequent losses. Otherwise, symptoms may worsen and the client may become depressed or engage in self-destructive behavior such as substance abuse. PTSD stems from events that cause moderate to severe stress reactions that may be experienced as a sense of horror, helplessness, serious injury, or threat of serious injury or death. Common precipitating events include combat, natural and man-made disasters, the sudden or unexpected death of a loved one, terrorist attacks, serious accidents or illnesses, sexual or physical assault, and various forms of abuse.
Option A: A special diet isn’t indicated unless the client also has an eating disorder or a nutritional problem. With proper training, health care professionals in multiple disciplines — including psychologists and psychiatrists, advanced social workers, licensed professional counselors, and psychiatric mental health nurse practitioners (PMHNPs) — can conduct PTSD interventions.
Option B: The physician may prescribe anti-anxiety agents or antidepressants cautiously to avoid dependence; sleep medication is rarely appropriate. PTSD symptoms can be treated with any of multiple types of medications, including antidepressants and anti-anxiety drugs. Prazosin has been identified as a possible aid in reducing or suppressing nightmares in some people with PTSD, but its efficacy is still being studied.
Option C: The client must explore the meaning of the event and won’t heal without this, no matter how much time passes. Behavioral techniques, such as relaxation therapy, may help decrease the client’s anxiety and induce sleep. A type of talk therapy, cognitive therapy helps patients recognize and modify potentially harmful thinking patterns, such as fears that traumatic events will recur.