Author Question: A patient who experienced a myocardial infarction was transferred from critical care to a step-down ... (Read 91 times)

geoffrey · **on:** Jul 19, 2018

A patient who experienced a myocardial infarction was transferred from critical care to a step-down unit. The patient then used the call bell every 15 minutes for minor requests and complaints.

Staff nurses reported feeling inadequate and unable to satisfy the patient's needs. When the nurse manager intervenes directly with this patient, which comment is most therapeutic?

a. I'm wondering if you are feeling anxious about your illness and being left alone.
b. The staff are concerned that you are not satisfied with the care you are receiving.
c. Let's talk about why you use your call light so frequently. It is a problem.
d. You frustrate the staff by calling them so often. Why are you doing that?

Question 2

A nurse assesses a patient diagnosed with conversion (functional neurological) disorder. Which comment is most likely from this patient?

a. Since my father died, I've been short of breath and had sharp pains that go down my left arm, but I think it's just indigestion.
b. I have daily problems with nausea, vomiting, and diarrhea. My skin is very dry, and I think I'm getting seriously dehydrated.
c. Sexual intercourse is painful. I pretend as if I'm asleep so I can avoid it. I think it's starting to cause problems with my marriage.
d. I get choked very easily and have trouble swallowing when I eat. I think I might have cancer of the esophagus.

sierramartinez · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

ANS: A
This patient is experiencing anxiety associated with a serious medical condition. Verbalization is an effective outlet for anxiety. I'm wondering if you are anxious focuses on the emotions underlying the behavior rather than the behavior itself. This opening conveys the nurse's willingness to listen to the patient's feelings and an understanding of the commonly seen concern about not having a nurse always nearby as in the intensive care unit. The other options focus on the behavior or its impact on nursing and do not help the patient with her emotional needs.

Answer to Question 2

ANS: A
Patients with conversion (functional neurological) disorder demonstrate a lack of concern regarding the seriousness of symptoms. This lack of concern is termed la belle indiffrence. There is also a specific, identifiable cause for the development of the symptoms; in this instance, the death of a parent would precipitate stress. The distracters relate to sexual dysfunction and illness anxiety disorder.