A patient with chronic pain tells the nurse I just want to give ...

[karateprodigy]

A patient with chronic pain tells the nurse I just want to give up all together. I am in so much pain every day, all the time. I don't want to do this anymore. Which is the priority nursing diagnosis for this patient?
 
  1. Hopelessness
  2. Powerlessness
  3. Spiritual distress
  4. Chronic pain

Question 2

The nurse is caring for a patient who is anticipating the loss of a limb following an accident. The patient states, I feel like I have no control over this. What nursing diagnosis is most appropriate for this patient?
 
  1. Powerlessness
  2. Hopelessness
  3. Spiritual distress
  4. Ineffective coping

[bulacsom]

Answer to Question 1

Answer: 1
Explanation: The priority nursing diagnosis for this patient is hopelessness, a state in which an individual feels restrained (without choices or alternatives) and immobilized. The nurse must recognize that the patient may be expressing thoughts of suicide, and the nurse must immediately assess for suicidal ideations. Though the patient is in chronic pain, it is the patient's hopelessness that takes priority. Powerlessness and spiritual distress may be aspects of the patient's current state; however, the patient's expression of hopelessness takes priority.

Answer to Question 2

Answer: 1
Explanation: Powerlessness is the most appropriate nursing diagnosis for this patient. Powerlessness is defined as the belief that one has no control over circumstances or outcomes. Hopelessness is a state in which an individual feels restrained (without choices or alternatives) and immobilized. While the patient expresses distress over the lack of choice for amputation, the patient states no control over the circumstance, indicating powerlessness, not hopelessness. Spiritual distress is best described by the disruption of an individual's capacity to assimilate or find meaning and purpose in his or her life by connecting with self, others, the arts, nature, and/ or a higher power. Ineffective coping is an impairment of problem solving skills, which the patient is not displaying.