A Chinese-American client comes to the mental health clinic after ...

[sam.t96]

A Chinese-American client comes to the mental health clinic after referral by her primary care physician.
 
  She complains of nervousness, headaches, fatigue, and vague GI symptoms for which no organic basis has been established. The symptoms began about 9 months ago when her favorite aunt died. The most appropriate independent nursing action would be to:
  1. Prescribe a trial course of antianxiety medication
  2. Plan strategies for cognitive behavioral therapy
  3. Arrange admission to the inpatient unit for a complete workup and psychologic testing
  4. Confer with the psychiatrist about the cultural association between depression and somatic symptoms

Question 2

A client with melancholic depression paces and wrings her hands for hours at a time. She tells the nurse, I'm a bad person. Staff members have been unsuccessful in their attempts to promote rest. An intervention of possible value would be:
 
  1. Insisting that the client lie down for 15 minutes of every hour
  2. Asking the client to fold and stack bath towels and washcloths
  3. Making the client aware of the negative effects of fatigue on mood
  4. Reassuring the client that she is accepted and not considered a bad person

[amandalm]

Answer to Question 1

ANS: 4
Expression of symptoms is influenced by ethnicity and culture. When depressed, Asian and Asian-American clients describe somatic symptoms, whereas clients of Western cultures may fo-cus on mood and cognitive symptoms. Option 4 is an appropriate independent intervention the nurse should take. Options 1, 2, and 3 would be considered collaborative, rather than independ-ent, interventions.

Answer to Question 2

ANS: 2
The psychomotor energy of agitation must be expended; it may be channeled into simple, repeti-tive activity. Standing in one place to fold towels is an improvement over pacing. 1. This client will be unable to comply with the request. 3. A severely depressed client will not be able to cog-nitively process this sort of information. 4. Reassurance will not appreciably affect the need for psychomotor activity.