A patient with severe orthopedic injuries after an automobile ...

[schs14]

A patient with severe orthopedic injuries after an automobile accident is irritable, angry, and belittles the nurses who provide his care.
 
  While the nurse is changing the dressing over a deep laceration, the patient screams, Don't touch me You are so stupid; you're only making it worse Which intervention would be most therapeutic? a. Wordlessly leave the room and ask to switch assignments with another nurse who may be more acceptable to the patient.
  b. Apologize, explain that the dressing change is necessary to prevent infection, and jointly explore ways to decrease the discomfort involved.
  c. State: Since you believe we nurses aren't able to change your dressing, perhaps you would like to change it yourself..
  d. State: This is frustrating for both of us, but there is no choice because your doctor has ordered this dressing change..

Question 2

The treatment team meets with a client for the first time and determines, with the client's input, a nursing diagnosis, goal, and steps to reach this goal.
 
  In addition to a nursing diagnosis, the treatment team has completed which phase of the nursing process? a. Evaluation
  b. Intervention
  c. Planning
  d. Assessment

[patma1981]

Answer to Question 1

B
Apologizing, explaining the need for the intervention, and jointly exploring options to reduce its discomfort make use of both validation and problem solving. Involving the patient in problem solving increases his sense of control over his circumstances. Loss of control over one's circumstances typically increases anxiety and often accompanies serious medical illnesses or trauma. If the nurse were unable to maintain a professional demeanor because of countertransference, leaving and switching assignments would be appropriate, but that situation is not indicated here. Suggesting the patient change his own dressing is a hostile response by the nurse designed to put him in his place; it may serve to vent the nurse's own frustration, but it is obviously not addressing the underlying causes of the patient's hostile acting out. Acknowledging that it is frustrating could be a helpful adjunctive intervention if accompanied by another response that addresses the root cause of the patient's acting out.

Answer to Question 2

C
During the planning phase, goals are established and a plan is developed. Evaluation is the phase in which goals are evaluated to determine whether they have been met, partially met, or not met at all; intervention is the phase of the nursing process when planned interventions are actually implemented; and data collection occurs during the assessment phase.

[schs14]

TYSM

[bitingbit]

Gracias!