A 14-year-old female inpatient, diagnosed with depression and self-mutilating behavior, is scheduled to be discharged in the morning
Her parents divorced when she was 10 and she hasn't seen her father for almost a year, but for the past three months she has been looking forward to his taking her to a special concert a few days after discharge. Her father has just called to tell his daughter he will not be able to make their "date" because he has been detained longer than expected on a business trip. The client takes the phone receiver and begins hitting herself in the chest with it. Which of the following nursing interventions will be most therapeutic in helping the client deal with her anger? 1. Provide emotional support by telling the client she has a right to be angry.
2. Tell the client you understand how she feels.
3. Revoke the discharge and transfer the client to a more restrictive environment.
4. Suggest that the client write her father a letter telling him how she feels.
4
Rationale: The most therapeutic response is to encourage the client to deal with her anger in a constructive, nonphysical manner. In this instance, the client is displacing her anger onto herself. By writing a letter she will be acknowledging her feelings and directing the anger at the source, which is her father. There is no need to move the client to a more restrictive environment unless she continues to harm herself. Telling her the nurse understands how she feels or that she has a right to be angry would not be a therapeutic response to the situation.
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