Fundamentals of Nursing Q 313
Albert, who suffered severe burns 6 months ago, is expressing concern about the possible loss of job-performance abilities and physical disfigurement. Which intervention is the most appropriate for him?
A. Referring the client for counseling and occupational therapy.
B. Staying with the client as much as possible and building trust.
C. Providing cutaneous stimulation and pharmacologic therapy.
D. Providing distraction and guided imagery techniques.
Correct Answer: A. Referring the client for counseling and occupational therapy
Because it has been 6 months, the client needs professional help to get on with life and handle the limitations imposed by the current problems. Staying with the client, building trust, and providing methods of pain relief, such as cutaneous stimulation, medications, distraction, and guided imagery interventions, would have been more appropriate in earlier stages of postburn injury when physical pain was most severe and fewer psychological factors needed to be addressed.
Option B: Explain to the patient what happened. Provide opportunities for questions and give honest answers. Compassionate statements reflecting the reality of the situation can help the patient and SO acknowledge that reality and begin to deal with what has happened.
Option C: The burned patient may require around-the-clock medication and dose titration. IV method is often used initially to maximize drug effect. Concerns of patient addiction or doubts regarding the degree of pain experienced are not valid during the emergent/acute phase of care, but narcotics should be decreased as soon as feasible and alternative methods for pain relief initiated.
Option D: Encourage use of stress management techniques: progressive relaxation, deep breathing, guided imagery, and visualization. Refocuses attention, promotes relaxation, and enhances the sense of control, which may reduce pharmacological dependency.