A nurse finds a psychiatric advance directive in the medical ...

[melly21297]

A nurse finds a psychiatric advance directive in the medical record of a patient experiencing psychosis. The directive was executed during a period when the patient was stable and competent. The nurse should:
 
  a. review the directive with the patient to ensure it is current.
  b. ensure that the directive is respected in treatment planning.
  c. consider the directive only if there is a cardiac or respiratory arrest.
  d. encourage the patient to revise the directive in light of the current health problem.

Question 2

The nurse should be particularly alert to somatization of psychological distress among patients whose cultural beliefs include: (select all that apply)
 
  a. mental illness reflects badly on the family.
  b. mental illness shows moral weakness.
  c. intergenerational conflict is common.
  d. the mind, body, and spirit are merged.
  e. food choices influence one's health.

[dajones82]

Answer to Question 1

ANS: B
The nurse has an obligation to honor the right to self-determination. An advanced psychiatric directive supports that goal. Since the patient is currently psychotic, the terms of the directive now apply.

Answer to Question 2

ANS: A, B, D
Physical symptoms are seen as more acceptable in cultural groups in which interdependence and harmony of the group are emphasized. Mental illness is often perceived as reflecting a failure of the entire family. In groups in which mental illness is seen as a moral weakness and both the individual and family are stigmatized, somatization of mental distress is better accepted. In groups in which mind, body, and spirit are holistically perceived, somatization of psychological distress is common. Somatization and food are not commonly related. Intergenerational conflict has not been noted as a risk factor for somatization.