Answer to Question 1
C
The patient has responded appropriately to the urge to harm herself by calling a helping individual. The nurse can assist the patient to choose an alternative to self-injury. Except when the patient is judged to be at risk of suicide as well, hospital or crisis center admissions are generally discouraged in favor of guiding the patient to use internal controls to manage urges to self-injure. This is designed to minimize dependence on hospitalization for safety and promote independence and adaptive coping. Taking a sedative and going to sleep should not be the first-line intervention, because sedation may reduce the patient's ability to weigh alternatives to mutilating behavior, and using medications to deal with stress (especially in the absence of other adaptive coping alternatives such as relaxation exercises) could increase the risk of drug abuse or dependence.
Answer to Question 2
1
The use of restraints is governed by federal and state laws, institutional policies, and special procedures.
A patient centered care approach
Patient teaching: heart assessment
Patient Education Follow-up Plan
Apply direct pressure to the patient’s wound.
A physical therapist helping the patient on parallel bars.
Dissociative Identity Disorder