When beginning care for a victim of rape, the nurse asks the patient to "talk about what happened" to her. For which nursing diagnosis is the nurse using this approach?
A) Anxiety related to recent rape
B) Fear related to repeated episodes of maltreatment
C) Disabling family coping related to recent rape of family member
D) Risk for other-directed violence related to admitted poor self-control
A
Feedback:
One need of any victim after a violent act is to talk about what happened because a person who can describe an incident can also begin to "put a fence around" or bring the event down from "something terrible has happened," a situation which leaves the person with a continuing high anxiety level, to "this specific thing has happened," a situation that allows the traumatic event to be examined and managed. Asking the victim to describe the incident to with an introduction such as "Most people find it helps to talk about what happened to them" helps the victim begin to put a fence around the incident. The nurse is not asking the patient to "talk about what happened" because of fear of maltreatment, disabling family coping related to the rape, or risk for violence related to poor self-control.
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