A client who has just been diagnosed with chronic myeloid leukemia (CML) is discussing anticipatory grieving. Which action by the nurse would be inappropriate at this time?

Question

1. Establish open communication and encourage sharing of feelings to discuss grieving.
2. Make referrals for support or bereavement groups.
3. Identify role changes and family stress management strategies.
4. Encourage the client to get affairs "in order" now to avoid waiting until it is too late.

Answer 1

4. Encourage the client to get affairs "in order" now to avoid waiting until it is too late.

Rationale:
Encouraging the client to get affairs "in order" now to avoid waiting until it is too late is not appropriate at this time: Although this topic is helpful to prepare for the actual death, this is not the time because this removes all hope. Establishing open communication and sharing of feelings to discuss grieving is appropriate at this time: The nurse should establish a rapport and use therapeutic communication to allow the client to express feelings and emotions about the new diagnosis of CML. Making referrals for support or bereavement groups is appropriate at this time: Offering information and resources about agencies that deal with grieving is an option to show the client that agencies can assist when the need is felt or when the client is ready to use them. In addition, this helps the client understand that anticipatory grieving is a normal process that occurs. Identifying role changes and family stress management strategies is appropriate at this time: Exploring possible role changes, stressors, and strategies associated with the disease progression will give the client a realistic approach to understanding the disease process and its consequences. This also helps the client begin to share with the family to build a foundation for mutual understanding and trust.