The nurse is caring for a client who has been given one year to live. Which of the following is a useful nursing intervention to treat the anxiety of the client and family associated with receiving a terminal diagnosis?
1. Explore the client and family's history with other stressful life events and how successful coping was at that time
2. Teach the family that while talking with the client about death and dying is permissible, they should not allow the client to dwell on death
3. Supply information about the client's disease process and the expected trajectory of death only on a need to know basis
4. Encourage early pharmaceutical intervention with anti-anxiety and sedative medications
1. Explore the client and family's history with other stressful life events and how successful coping was at that time
Rationale:
It is most helpful for the nurse to know how the client and family have dealt with previous stressful life events so that support of positive coping mechanisms can occur. The client who has received a terminal diagnosis needs to discuss the future and the implications of the diagnosis. The need for discussion and the amount of time needed will vary from client to client, so "dwelling" is an inappropriate descriptor. The client must be given facts about the disease process and projected trajectory so that final business and relationships can be addressed. Early use of anti-anxiety and sedative medications is not appropriate because these medications can adversely affect the client's ability to think clearly about the future.
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