You are caring for the 27-year-old mother of 2-year-old twins
She was diagnosed 18 months ago with primary progressive multiple sclerosis and has just been told that she will probably be confined to a wheelchair within a few months. When the home health nurse makes a routine visit to the patient, the nurse finds her tearful, lethargic, and appearing disheveled. The patient tells the nurse, "I used to think I could cope with this awful disease, but I just don't know anymore. I have become such a disaster that I can't do anything anymore." What behaviors in the patient would lead the nurse to suspect acute depression in this patient?
A) Increased self-esteem
B) Claims of improvement in function
C) Changes in the patient's thoughts or feelings
D) Denial of physical progression of the disease
Ans: C
Chapter: 7
Client Needs: C
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3
Page and Header: 100, Mental Health and Emotional Distress
Feedback: Any loss in function, change in role, or alteration in body image is a possible antecedent to depression. Nurses in all settings encounter patients who are depressed or who have thought about suicide. Depression is suspected if changes in the patient's thoughts or feelings and a loss of self-esteem are noted. Increased self-esteem would not indicate depression; it would indicate alterations in coping for this patient. Claims of improvement in function and denial of the physical progression of the disease are also not indications of depression. Denial is a stage in the grieving process, and claims of functional improvement are a means of denial of the progression of the disease.
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