A seriously mentally ill woman has frequent relapses of her illness, usually precipitated by situational stressors such as running out of money or the vacations of key staff members at her mental health center. Which interventions would her nurse suggest to keep stressors from causing relapses?
a. Help the patient identify and anticipate events that are likely to overwhelm her.
b. Guide her to develop written crisis plans that will help her remember what to do in crises.
c. Apply for a court-appointed guardian to take charge of her affairs until she stabilizes.
d. Encourage health-promoting activities such as exercise and getting adequate rest.
e. Discourage potentially stressful activities such as groups or volunteer work.
f. Accompany the patient to a National Alliance on Mental Illness support group.
A, B, D, F
Basic interventions for coping with crises involve anticipating crises where possible and then developing a plan with specific actions to take when faced with an overwhelming stressor. Written plans are helpful; it can be difficult for anyone, especially a person with cognitive or memory impairments, to develop or remember steps to take when under overwhelming stress. Health-promoting activities enhance a person's ability to cope with stress. As the name suggests, support groups help a person develop a support system, and they provide practical guidance from peers who learned from experience how to deal with issues the patient may be facing. Guardianship is a measure that, while beneficial when other options have not worked, can take control from the patient, reducing independence and self-esteem. Groups and volunteer work may involve a measure of stress but also provide benefits that help persons cope and should not be discouraged unless they are being done to excess.
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