The nurse is working with a wife who is caring for her ...

[tichca]

The nurse is working with a wife who is caring for her chronically ill husband who requires around-the-clock care. The nurse notices that the wife often speaks to her husband sharply.
 
  The bed linens are soiled with food and the patient has a strong body odor. Both the house and the wife are unkempt. When encouraged to talk, the wife says, I just drag around. I can't make myself do anything. I'm so tired of it all. What nursing diagnosis best fits these defining characteristics?
  a. Dysfunctional Family Processes
  b. Caregiver Role Strain
  c. Defensive coping
  d. Impaired Verbal Communication

Question 2

The nursing student is caring for a seriously ill child on the pediatric unit. There are many family members present, including parents, aunts, and uncles.
 
  The student tells the primary nurse, Every time I go into the room, everyone is shouting at each other, they shout at me, and they ask me the same questions over and over. What is the most appropriate response by the nurse?
  a. This is unacceptable and disruptive behavior. Let them know that if this behavior continues, we may need to call security.
  b. Families experience a range of emotions when caring for an ill member. Sometimes these are normal reactions, so you need not take it personally.
  c. There may be too many people in the room. You might consider limiting their visiting time.
  d. I believe this family is of Italian descent. Don't worry about it; it may just be their culture.

[rachel]

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.

[tichca]

TYSM

[mjenn52]

Excellent