A person diagnosed with serious mental illness has frequent relapses, usually precipitated by situational stressors such as running out of money or the absence of key staff at the mental health center. Which interventions would the nurse suggest to reduce the risk of stressors to cause relapse? Select all that apply.
a. Discourage potentially stressful activities such as groups or volunteer work.
b. Develop written plans that will help the patient remember what to do in a crisis.
c. Help the patient identify and anticipate events that are likely to be overwhelming.
d. Encourage health-promoting activities such as exercise and getting adequate rest.
e. Accompany the patient to a National Alliance on Mental Illness support group.
ANS: B, C, D, E
Basic interventions for coping with crises involve anticipating crises where possible and then developing a plan with specific actions to take when faced with an overwhelming stressor. Written plans are helpful; it can be difficult for anyone, especially a person with cognitive or memory impairments, to develop or remember steps to take when under overwhelming stress. Health-promoting activities enhance a person's ability to cope with stress. As the name suggests, support groups help a person develop a support system, and they provide practical guidance from peers who learned from experience how to deal with issues the patient may be facing. Groups and volunteer work may involve a measure of stress but also provide benefits that help persons cope and should not be discouraged unless they are being done to excess.
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