The client is a homeless veteran who has been staying at a shelter since discharge after serving in Iraq

Question

The client has become increasingly irritable over the last two weeks and might be evicted from the shelter if the client's behavior does not improve. The nurse learns that the client has not had more than a few hours of sleep in the last two days. Which diagnosis would be most appropriate for this client at this time? 1. Sleep pattern disturbance related to anticipation of threat to basic needs and security
2. Alteration in self-concept related to survivor guilt
3. Potential for self-harm related to irritability secondary to sleeplessness
4. Posttraumatic stress disorder related to combat experiences

Answer 1

1
Rationale: The client appears to be experiencing sleep pattern disturbance related to the stress of the threatened loss of shelter. The client may or may not be experiencing survivor guilt or posttraumatic stress disorder, but that is not the priority diagnosis at this time. There is no indication the client is having thoughts of self-harm.