Two nurses are discussing a new patient during report. They ...

[piesebel]

Two nurses are discussing a new patient during report. They discover that she has the staff divided on their opinion of her. One group has had very positive interactions with her and find her to be very cooperative.
 
  The other group has had a difficult time in gaining her compliance in treatment interventions. What action would be most appropriate in dealing with this situation? a. Provide consistent limit setting with the client.
  b. Assign the staff with the positive interactions to the client's care.
  c. Work with the group experiencing the negative interactions to maintain an accepting attitude.
  d. Take away privileges from the client until she changes her behavior.

Question 2

A 10-year-old patient on a children's oncology unit has had an unsuccessful bone marrow transplant. The family is distraught but remains positive in front of the child. One night the child asks the nurse about death and dying.
 
  What counseling should the nurse give to the parents? a. Avoid talking about death in front of the child.
  b. Change the subject if the child asks about dying.
  c. Allow the child to have an honest discussion about dying.
  d. Allow the physician to discuss this with the child.

[connor417]

Answer to Question 1

A
Clients use a technique called splitting, emotionally dividing the staff by complimenting one group and degrading another. Consistent limit setting and reinforcement help clients to define their limits, but care providers must keep in mind their own therapeutic boundaries and communicate with each other frequently.

Answer to Question 2

C
Children are remarkably observant and have an intuitive ability to understand the seriousness of their illness and its outcomes. Whenever possible, parents should be encouraged to communicate with the dying child. Open discussions of the illness and its outcomes help children cope with feelings of isolation, anxiety, and guilt over causing distress in the family. The other options continue to isolate the child and encourage suppression of feelings.