A patient being treated in the burn injury unit has demonstrated good coping skills for several weeks. Today, a new nurse is assigned to care for him and has proven to be poorly organized
The patient's usual schedule has not been followed, and by midafternoon, he is angry and raises his voice to complain to the nurse clinician. Which course of action for the nurse clinician would be best? a. Explain the reasons for the problem, and take over his care for the rest of the shift.
b. Validate his distress, review the options, and ask what he would like to happen.
c. Apologize and ask that he be patient with the situation for the rest of the shift.
d. Ask him to control his anger, and ask him if he too wasn't once new at something.
B
When a patient with good coping skills is angry and overwhelmed, the goal is to reestablish a means of dealing with the situation. The nurse should problem solve with the patient by acknowledging and validating the patient's feelings as understandable, then assuring that the patient has a role in seeking an acceptable solution. Often patients can tell the nurse what they would like to have happen as a reasonable first step. Taking over the care would not necessarily be what the patient wants; for example, despite his distress with the novice, he might not want her to "get into trouble" or be replaced. Asking him to be patient because of staffing needs puts the needs of staff and the hospital ahead of the needs of the patient. Reminding him that he was also once a novice in some respect could induce guilt and would be a disconfirming (nontherapeutic) statement in that it invalidates his anger.
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The nurse's response should be: 1. "Heparin may be given by mouth, while Coumadin must be injected." 2. "Heparin is safer because it does not cross the placenta." 3. "They are the same drug, but heparin is less expensive." 4. "Coumadin interferes with iron absorption in the intestines."
The nurse enrolled in graduate courses is able to continue studies while visiting abroad. What has this nurse's nursing school implemented to make this possible?
1. Classroom technology 2. Distance learning 3. CAI 4. Informatics
The theory of Hildegard Peplau is relevant to the practice of psychiatric nursing because it focuses on:
a. meeting the client's physical needs b. a holistic perspective of the client c. communication between the client and others d. the nurse-client relationship
A client in labor is concerned about needing a cesarean section and being asleep during the birth of her baby. Which nursing response is most appropriate?
1. "Your anesthesia provider will require that you go to sleep for surgery." 2. "If a cesarean section is needed, that does not necessarily mean you will need to go to sleep for surgery." 3. "We will do our best to make sure you deliver vaginally, so you do not need to have a cesarean section." 4. "If you need a cesarean section, the anesthesia provider will awaken you as soon as possible after delivery so that you can see your baby quickly."