A client with depression is admitted for voluntary treatment. While in the hospital, the client makes several comments about leaving the facility and kiling themselves with their gun. Which is the most appropriate action by the nurse when the client requests to leave against medical advice?
Call security and ask them to detain the client from leaving.
Contact the client's family to request they convince the client to stay.
Allow the client to leave, with a referral to community resources for follow-up care.
Contact the psychiatrist for initiation of commitment proceedings.
The Correct Answer is D
In this situation, the client's safety is of utmost importance. Expressing a desire to leave the facility and harm oneself with a gun raises serious concerns about the client's safety and the risk of harm to themselves. Initiating commitment proceedings, also known as involuntary hospitalization or psychiatric hold, allows the facility to legally detain the client temporarily for their protection and evaluation by mental health professionals. This allows for a thorough assessment of the client's mental health status and the formulation of a comprehensive treatment plan to ensure their safety.
Options A, B, and C are not appropriate in this situation:
A. Calling security to detain the client may escalate the situation and could potentially lead to increased risk of harm.
B. Contacting the client's family may not be enough to ensure the client's safety, and it is essential to involve mental health professionals in evaluating the client's risk.
C. Allowing the client to leave without addressing their expressed suicidal ideation is not safe, as the client may be at high risk for self-harm or suicide. Simply referring them to community resources without further evaluation and intervention is not sufficient to address the immediate safety concern.
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Correct Answer is D
Explanation
The statement, "I will find a support group to help me through this," indicates that the client's coping skills are adequate. Seeking support from others who have experienced a similar loss can be an effective way to cope with feelings of loneliness and vulnerability after the death of a spouse. Support groups provide a safe and understanding environment where individuals can share their experiences, feelings, and struggles, and receive emotional support from others who can relate to their situation.
Option A suggests an overconfidence in coping skills and may not fully acknowledge the need for external support during a challenging time.
Option B indicates a sense of feeling abandoned, which could be a sign of struggling coping skills.
Option C suggests confusion and difficulty accepting the loss, which may indicate inadequate coping skills at the moment.
Correct Answer is C
Explanation
Option C demonstrates empathy and active listening. By acknowledging the client's emotions and expressing concern, the nurse creates a safe and supportive environment for the client to share their feelings. This response encourages the client to open up and express what they are going through, allowing the nurse to better understand the situation and provide appropriate care and support.
Options A and D are also empathetic but may not prompt the client to share their feelings or concerns as effectively as Option C.
Option B is not appropriate as it minimizes the client's emotions and may discourage them from expressing their feelings further.
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