A hospice nurse is caring for a client who has been given 6 ...

[jace]

A hospice nurse is caring for a client who has been given 6 months to live. Which nursing intervention would address the anxiety of the client and family associated with receiving a terminal diagnosis?
 
  A) Encourage early pharmaceutical intervention with anti-anxiety and sedative medications to ease the grieving process.
  B) Teach the family that while talking with the client about death and dying is permissible, they should not allow the client to dwell on death.
  C) Explore the client and family's history with other stressful life events and how successful coping was at that time.
  D) Supply information about the client's disease process and the expected trajectory of death only on a need-to-know basis.

Question 2

A client experiencing situational depression after losing a good job tells the nurse, I am tired of always having to start over. Which actions by the nurse are appropriate based on this data? Select all that apply.
 
  A) Ask what the client has done in the past to make starting over so successful.
  B) Suggest the client talk with the physician about medications to help his mood.
  C) Remind the client that an alcoholic beverage with the evening meal could help with stress.
  D) Encourage the client to take the time to rest and relax.
  E) Encourage the client to maintain a consistent exercise plan.

[ecox1012]

Answer to Question 1

Answer: C

It is most helpful for the nurse to know how the client and family have dealt with previous stressful life events so that support of positive coping mechanisms can occur. The client who has received a terminal diagnosis needs to discuss the future and the implications of the diagnosis. The need for discussion and the amount of time needed will vary from client to client, so dwelling is an inappropriate descriptor. The client must be given facts about the disease process and projected trajectory so that final business and relationships can be addressed. Early use of anti-anxiety and sedative medications is not appropriate because these medications can adversely affect the client's ability to think clearly about the future.

Answer to Question 2

Answer: A, D, E

The nurse needs to assess the client's resiliency by finding out what he was able to do in the past, in similar situations, to be successful. Exercise has been shown to improve cognitive function, elevate mood, and relieve stress and anxiety. Suggesting that the client needs medication is inappropriate without further assessment. The nurse should not encourage the client to rest and relax because this could lead to a major depressive episode. The nurse should not encourage the client to ingest alcohol because this can be a self-destructive behavior.