Substance Abuse and Abuse Q 28
Which of the following nursing actions would be included in a care plan for a client with PTSD who states the experience was “bad luck”?
A. Encourage the client to verbalize the experience.
B. Assist the client in defining the experience.
C. Work with the client to take steps to move on with his life.
D. Help the client accept positive and negative feelings.
Correct Answer: B. Assist the client in defining the experience.
The client must define the experience as traumatic to realize the situation wasn’t under his personal control. Encourage the client to talk about traumatic experiences under non-threatening conditions. Help the client work through feelings of guilt related to the traumatic event. Help the client understand that this was an event to which most people would have responded in like manner. Support the client during flashbacks of the experience. Verbalization of feelings in a non-threatening environment may help the client come to terms with unresolved issues.
Option A: Encouraging the client to verbalize the experience without first addressing the denial isn’t a useful strategy. When the level of anxiety has been reduced, explore with the client the possible reasons for the occurrence. Recognition of precipitating factors is the first step in teaching the client to interrupt escalation of anxiety. Avoid asking or forcing the client to make choices. The client may not make sound and appropriate decisions or may be unable to make decisions at all.
Option C: The client can move on with life only after acknowledging the trauma and processing the experience. Present and discuss the reality of the situation with the client in order to recognize aspects that can be changed and those that cannot. The client must accept the reality of the situation before the work of reducing fear can progress. Encourage the client to explore underlying feelings that may be contributing to irrational fears. Help the client to understand how facing these feelings, rather than suppressing them, can result in more adaptive coping abilities.
Option D: Acknowledgement of the actual trauma and verbalization of the event should come before the acceptance of feelings. Explore things that may lower fear level and keep it manageable (e.g. singing while dressing, repeating a mantra, practicing positive self-talk while in a fearful situation). Provides the client with a sense of control over the fear. Distracts the client so that fear is not totally focused on and allowed to escalate.