The children of an older female adult ask the nurse for advice ...

[future617RT]

The children of an older female adult ask the nurse for advice about helping their mother heal after her husband's death. Which strategy should the nurse share with the family?
 
  a. Appoint one family member to take her on outings.
  b. Coordinate family expressions of care and concern.
  c. Have each child plan a long trip with her assistance.
  d. Take her to community events to meet other people.

Question 2

An older man who had radical surgery for oral cancer is refusing to see visitors and is losing weight, despite aggressive nutrition therapy. The nurse assesses this man for ineffective coping, related to dysfunctional grieving.
 
  Which of the following patient outcomes of nursing care is the most important to implement in response to his mental health status? a. Is able to discuss how his coping mechan-isms are overwhelmed.
  b. Performs daily self-feedings through a gastrostomy tube.
  c. Effectively uses nonverbal forms of communication.
  d. Exhibits self-confidence in regaining a sense of control.

[ApricotDream]

Answer to Question 1

B

Feedback
A Incorrect. One person is unlikely to provide enough support for the bereaved, and this can potentially imply that only one person is concerned.
B Correct. The nurse suggests that the family work together to provide extended expressions of caring and concern for their mother because many small expres-sions of concern and caring from several sources help the bereaved to gain the strength and confidence needed to survive a huge loss.
C Incorrect. Multiple small gestures are more likely to help build strength and confidence than a few large gestures.
D Incorrect. Helping a widow meet new people can be unsuitable because she can be uninterested or unwilling to attend events for meeting new people. In addi-tion, she can feel that the family is trying to find a replacement for the deceased to ease the family's burden. However, the family can offer to accompany her to such events.

Answer to Question 2

D
The most important element of the nursing plan of care for this older adult is to create and strengthen self-confidence to improve his sense of control; doing so is likely to help him effec-tively manage the other aspects of his health care. The nurse helps create and improve this self-confidence by observing for strengths and integrating them into his daily care and by res-ponding with empathy and encouragement to his expressions of fears, emotions, and desirable goals. Helping this patient gain self-confidence is the most important outcome because this man has clinical indicators for depressionsocial isolation and weight loss.
Before this patient can benefit from discussing his stressors or from patient teaching, the nurse must establish a trusting, caring relationship and build some self-confidence because, at this point, this individual feels hopeless and believes that he has no control. The patient displays a lack of readiness for expressions about emotions, coping, or his stressors; by enhancing his self-confidence, the nurse prepares him to discuss coping mechanisms and stressors. This patient also displays a lack of readiness for learning a new psychomotor activity. Performing daily self-feeding is an outcome that gains importance as the day for discharge approaches. Effectively using nonverbal forms of communication is important for basic communication; however, he displays a lack of readiness for receiving help to achieve this outcome.