Author Question: A 38-year-old patient has returned home following rehabilitation for a spinal cord injury. The home ... (Read 59 times)

tth

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A 38-year-old patient has returned home following rehabilitation for a spinal cord injury. The home care nurse notes that the spouse is performing many of the activities that the patient had been managing unassisted during rehabilitation.
 
  The most appropriate action by the nurse at this time is to
  a. remind the patient about the importance of independence in daily activities.
  b. tell the spouse to stop because the patient is able to perform activities independently.
  c. develop a plan to increase the patient's independence in consultation with the patient and the spouse.
  d. recognize that it is important for the spouse to be involved in the patient's care and encourage that participation.

Question 2

A 20-year-old patient who sustained a T2 spinal cord injury 10 days ago angrily tells the nurse I want to be transferred to a hospital where the nurses know what they are doing Which action by the nurse is best?
 
  a. Clarify that abusive language will not be tolerated.
  b. Request that the patient provide input for the plan of care.
  c. Perform care without responding to the patient's comments.
  d. Reassure the patient about the competence of the nursing staff.



fromAlphatoOmega22

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Answer to Question 1

ANS: C
The best action by the nurse will be to involve all the parties in developing an optimal plan of care. Because family members who will be assisting with the patient's ongoing care need to feel that their input is important, telling the spouse that the patient can perform activities independently is not the best choice. Reminding the patient about the importance of independence may not change the behaviors of the spouse. Supporting the activities of the spouse will lead to ongoing dependency by the patient.

Answer to Question 2

ANS: B
The patient is demonstrating behaviors consistent with the anger phase of the grief process, and the nurse should allow expression of anger and seek the patient's input into care. Expression of anger is appropriate at this stage, and should be accepted by the nurse. Reassurance about the competency of the staff will not be helpful in responding to the patient's anger. Ignoring the patient's comments will increase the patient's anger and sense of helplessness.



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