Psychiatric Medications Q 54
A dying male client gradually moves toward resolution of feelings regarding impending death. Basing care on the theory of Kubler-Ross, Nurse Trish plans to use nonverbal interventions when assessment reveals that the client is in the:
A. Anger stage
B. Denial stage
C. Bargaining stage
D. Acceptance stage
Correct Answer: D. Acceptance stage
Communication and intervention during this stage are mainly nonverbal, as when the client gestures to hold the nurse’s hand. Provide time for acceptance, final farewell, and arrangements for memorial or funeral service according to individual spiritual, cultural, ethnic needs. Accommodation of personal and family wishes helps reduce anxiety and may promote a sense of peace.
Option A: Assess the level of anxiety present in the family and/or SO. Anxiety level needs to be dealt with before problem-solving can begin. Individuals may be so preoccupied with their own reactions to the situation that they are unable to respond to another’s needs. Establish rapport and acknowledge the difficulty of the situation for the family. May assist SO to accept what is happening and be willing to share problems with staff.
Option B: Determine the level of impairment of perceptual, cognitive, and/or physical abilities. Evaluate illness and current behaviors that are interfering with the care of the patient. Information about family problems will be helpful in determining options and developing an appropriate plan of care.
Option C: Assist family and patient to understand “who owns the problem” and who is responsible for resolution. Avoid placing blame or guilt. When these boundaries are defined, each individual can begin to take care of their own self and stop taking care of others in inappropriate ways.