Answer to Question 1
B
The defining characteristics best fit a nursing diagnosis of Caregiver Role Strain. The caregiver exhibits dysfunctional communication (speaking sharply), is not performing well in the caregiver role (soiled bed linens, patient's body odor), and is experiencing and expressing depressive symptoms. Dysfunctional Family Processes usually include denial of problems, resistance to change, and a series of crises; depression is not a symptom. Defensive coping is more about a falsely positive self-evaluation; this woman does not seem defensive, but admits she is having difficulty. Although the wife's communication may sound angry, her verbal communication is not really impaired. Impaired Verbal Communication is characterized by difficulty in receiving, processing, and/or using words to communicate. Furthermore, a diagnosis of Impaired Verbal Communication would not address the wife's depression and inability to provide satisfactory care.
Answer to Question 2
B
When a family member is ill or hospitalized, the other family members experience a range of emotionsespecially when the illness is severe or of sudden onset. Family members may display signs of stress in a variety of ways, for example, by arguing with each other or with healthcare providers, in insisting on immediate care for their loved one, by being critical of the care provided, or by frequently asking that information be repeated. These are normal reactions; do not take them personally. Limiting visiting hours is not always beneficial, especially when dealing with children. There are times to call security if the behavior escalates and begins to affect other patients and families. In this instance, citing a cultural connection is inappropriate as it reflects stereotyping and is judgmental.