The spouse of a patient in hospice care angrily tells the nurse, ...

[asd123]

The spouse of a patient in hospice care angrily tells the nurse, The care provided by the aide and other family members is inadequate, so I must do everything myself. Why can't anyone do things right? The palliative care nurse should:
 
  a. provide teaching about anticipatory grieving.
  b. assign new personnel to the patient's care.
  c. arrange hospitalization for the patient.
  d. refer the spouse for crisis counseling.

Question 2

An individual was killed during a store robbery 2 weeks earlier. The widowed spouse, who has schizoaffective disorder, cries spontaneously when talking about the death. Which is the nurse's most therapeutic comment?
 
  a. I'm worried about how much you're crying. Your grief over your spouse's death has gone on too long.
  b. The unexpected death of your spouse must be so painful. I'm glad you're able to talk to me about your feelings.
  c. This loss is harder to accept because of your mental illness. Let's refer you to the partial hospitalization program.
  d. Your crying shows me you aren't coping well. I made an appointment for you to see the psychiatrist for medication adjustment.

[tsternbergh47]

Answer to Question 1

ANS: A
The behaviors described in this scenario are consistent with anticipatory grieving. The spouse needs to be taught about the process of anticipatory grieving and to receive counseling to validate what she is experiencing and to enhance coping. The other options are not appropriate to the situation.

Answer to Question 2

ANS: B
The patient is expressing feelings related to the loss, and this is an expected and healthy behavior. This patient is at risk for dysfunctional grieving because of the history of a severe psychiatric illness, but the nurse's priority intervention is to form a therapeutic alliance and support the patient's expression of feelings. The patient's crying 2 weeks after the spouse's death is expected and normal.

[asd123]

Thank you

[tsternbergh47]

Happy to help you