A nurse is meeting with a 14-year-old girl who reveals that she frequently engages in cutting. Which thought of the nurse's would be most therapeutic?
1. She must be depressed.
2. She needs an immediate medication evaluation.
3. This is typical behavior adolescent behavior and not really a big problem.
4. I must make sure she is safe and then I think we will need to work on this patient developing new coping skills.
Answer: 4
Explanation: Regardless of the trigger, nursing care of the self-injurious child or adolescent is to ensure safety first, and then to help the patient develop new skills for problem solving and managing difficult emotions and interpersonal conflicts. Adolescents who self-injure differ from those with depression. Medication is not necessarily indicated in self-injury. Adolescents who self-injure may evidence delinquent behavior, PTSD symptoms, substance and tobacco use, greater degrees of hopelessness, higher impulsivity, and suicidal ideation.
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