An adult confides to a nurse, The cancer in my neck spread in ...

[MirandaLo]

An adult confides to a nurse, The cancer in my neck spread in only 2 months. That is how my whole life has been. No matter what I do, I am sabotaged.. As this patient faces the prospect of dying, which motif is evident?
 
  a. Quest: seeking meaning in dying
  b. Volatile: unresolved and unresigned
  c. Endurance: triumph of inner strength
  d. Incorporation: belief system accommodates death

Question 2

A patient hospitalized after an MI is restlessly moving about in bed. Her pulse, blood pressure, and respiratory rate are elevated.
 
  In a shaky voice, she tells the nurse, I think I am going to die. The pain is gone, but it could come back anytime. Where is the doctor? Why isn't the doctor here with me? Place the nursing interventions in the order that would make them most therapeutic.
  A. I want you to breathe slowly with me, counting to 3 as you breathe in and again as you breathe out. I think this will help, but if not, I'll call your doctor..
  B. You seem very anxious, which is understandable. Your vital sounds are up a bit because you are anxious, not because there is a problem with your heart..
  C. We are watching you very closely via the monitors and will be here in moments if there is a problem, so you can rest easy now, knowing we are watching over you..
  D. A heart attack can be a very frightening experience. Would you like to talk about it with me for awhile?

[potomatos]

Answer to Question 1

B
The patient's comment demonstrates lack of control over major forces in life. The volatile motif is characterized by feelings that are unresolved and unresigned. The quest motif seeks meaning in the experience of dying. The endurance motif includes the triumph of inner strength. The incorporation motif accommodates life and death.

Answer to Question 2

1 . B
2 . A
3 . D
4 . C
The patient is highly anxious, elevating her vital signs and producing physical sensations she interprets as a worsening of her cardiac condition. She seems to feel less secure because what she perceives as the necessary help she might need (her doctor) is not at hand. The first step is to acknowledge her distress and provide information to reassure her that her heart condition remains stable. The second step would be to reduce her anxiety by walking her through a deep breathing exercise, which also serves to teach her how to do this on her own in the future and to assure her that the doctor, while not needed now, will be contacted immediately if circumstances change. The third step, after her anxiety has been reduced sufficiently to allow her to respond to verbal interventions, is to discuss her health concerns and coping options. The last step is to further reduce her anxiety by reassuring her that staff will know at once if her condition worsens and help her without delay, which further addresses her concern about help being nearby.