A mother of a 5-year-old child, with complex health care needs ...

[pepyto]

A mother of a 5-year-old child, with complex health care needs and cared for at home, expresses anxiety about attending a kindergarten graduation exercise of a neighbor's child.
 
  The mother says, I wish it could be my child graduating from kindergarten. The nurse recognizes that the mother is experiencing:
  a. abnormal anxiety.
  b. ineffective coping.
  c. chronic sorrow.
  d. denial.

Question 2

The home care nurse has been visiting an adolescent with recently acquired quadriplegia. The teen's mother tells the nurse, I'm sick of providing all the care while my husband does whatever he wants to, whenever he wants to do it.
 
  Which should be the initial action of the nurse?
  a. Refer mother for counseling.
  b. Listen and reflect mother's feelings.
  c. Ask father, in private, why he does not help.
  d. Suggest ways the mother can get her husband to help.

[frankwu0507]

Answer to Question 1

ANS: C
Home care nurses should be aware that parents may experience chronic sorrow as a parental stressor. Chronic sorrow as a normal grief response is associated with a living loss (the loss of a healthy child) that is cyclical in nature. This is a normal response and does not indicate abnormal anxiety, ineffective coping, or denial.

Answer to Question 2

ANS: B
It is appropriate for the nurse to reflect with the mother about her feelings, exploring issues such as an additional home health aide to help care for the child and provide respite for the mother. It is inappropriate for the nurse to agree with the mother that her husband is not helping enough. It is a judgment beyond the role of the nurse and can undermine the family relationship. Counseling is not necessary at this time. A support group for caregivers may be indicated. Asking the father why he does not help and suggesting ways to the mother to get her husband to help are interventions based on the mother's assumption of minimal contribution to the child's care. The father may have a full-time job and other commitments. The parents need to have an involved third person help them through the negotiation of responsibilities for the loss of their normal child and new parenting responsibilities.

[pepyto]

TYSM

[recede]

Excellent