Substance Abuse and Abuse Q 10
The depressed client verbalizes feelings of low self-esteem and self-worth typified by statements such as “I’m such a failure… I can’t do anything right!” The best nursing response would be:
A. To tell the client this is not true; that we all have a purpose in life.
B. To remain with the client and sit in silence; this will encourage the client to verbalize feelings.
C. To reassure the client that you know how the client is feeling and that things will get better.
D. To identify recent behaviors or accomplishments that demonstrate skill ability.
Correct Answer: D. To identify recent behaviors or accomplishments that demonstrate skill ability.
Feelings of low self-esteem and worthlessness are common symptoms of the depressed client. An effective plan of care to enhance the client’s personal self-esteem is to provide experiences for the client that are challenging but will not be met with failure. Reminders of the client’s past accomplishments or personal successes are ways to interrupt the client’s negative self-talk and distort the cognitive view of self. Silence may be interpreted as agreement.
Option A: Assess the self-esteem level of the patient. Signs of low self-esteem include withdrawal from social relationships, feeling of inadequacy, neglect of personal hygiene and dress, and rejecting self which all may indicate a negative thought pattern. Allow the patient to perform personal care activities. Paying attention to grooming serves as a first step towards achieving positive self-image.
Option B: Give positive feedback after a task is achieved. Positive reinforcement has a big part in building self-esteem. Teach visualization techniques that can help the client replace negative self-images with more positive images and thoughts to promote a healthier and more realistic self-image by helping the client choose more positive thoughts and actions.
Option C: This gives advice and devalues the client’s feelings. Encourage the client to participate in a group therapy where the members share the same situations/feelings that they have to minimize the feelings of isolation and provide an atmosphere where positive feedback and a more realistic appraisal of self are available. Involve the client in activities that he or she wants to improve by using problem-solving skills. Assess and evaluate the need for more teaching in this area.