A patient in a dimly lit room demonstrates fluctuating levels of ...

[shofmannx20]

A patient in a dimly lit room demonstrates fluctuating levels of consciousness, disturbed orientation, and perceptual alterations and begs the nurse to get the bugs off her. Which nursing response would be most therapeutic?
 
  a. There are no bugs on your legs. Your imagination is playing tricks on you..
  b. Try to relax. The crawling sensation will go away sooner if you can relax..
  c. Don't worry, I will have someone stay here and brush away the bugs for you..
  d. I don't see bugs, but I'll stay with you and brighten the lights so we can be sure..

Question 2

If illness or hospitalization results in a change in physical appearance, it is likely to have a strong impact on the person's
 
  1. attitude.
  2. body image.
  3. confidence.
  4. acceptance of the problem.

[leeeep]

Answer to Question 1

D
Staying with the patient increases feelings of security, reduces anxiety, offers the opportunity for reinforcing reality, and provides a measure of physical safety. Brightening the lights allows the patient to reassess reality and enables her to question whether her experience was real or mistaken. Also, if she can see that no insects are present despite her sensations, she will likely experience a reduction in anxiety. When hallucinations are present, the nurse should acknowledge the patient's feelings and state the nurse's perception of reality but not refute the patient's experience. Your imagination is playing tricks on you does not meet these guidelines for intervention and does not support the patient emotionally. Directing the patient to relax sets up an unrealistic expectation, given what she perceives is happening. Indicating that someone will brush the bugs away suggests that the patient's perceptions are based in reality and reinforces the hallucinatory experience.

Answer to Question 2

2
Threats to body image occur with surgery, extensive diagnostic procedures, and acute and chronic illness.