A nurse has described the behavioral health unit being based on milieu therapy to a client. The client asks, "How is a unit that has milieu therapy different from other hospital units?" Which of the following responses should the nurse make?

The correct answer is: A, D, E, and F.

Choice A reason:

Muscular tension, blood pressure, and triglycerides increase. Long-term stress can lead to chronic muscle tension, elevated blood pressure, and increased triglyceride levels. Chronic muscle tension is a common response to prolonged stress, often resulting in pain and discomfort. Elevated blood pressure is a well-documented effect of chronic stress, which can increase the risk of cardiovascular diseases. Increased triglycerides are also associated with prolonged stress, contributing to metabolic syndrome and cardiovascular risk.

Choice B reason:

Epinephrine is released, increasing heart and respiratory rates. This response is more characteristic of acute stress rather than long-term stress. Epinephrine (adrenaline) is released during the “fight-or-flight” response, causing immediate increases in heart rate and respiratory rate. However, this is a short-term physiological response and not typically sustained over long periods.

Choice C reason:

Corticosteroid release increases stamina and impedes digestion. While corticosteroids like cortisol are released during stress, their primary long-term effect is not to increase stamina but to manage energy by increasing blood glucose levels through gluconeogenesis. Chronic cortisol release can indeed impede digestion by diverting energy away from non-essential functions like the digestive system.

Choice D reason:

Cortisol is released, increasing gluconeogenesis and reducing fluid loss. Cortisol, a key stress hormone, is released during long-term stress and increases gluconeogenesis, which is the production of glucose from non-carbohydrate sources. This helps maintain energy levels during prolonged stress. Cortisol also helps in reducing fluid loss by promoting sodium retention in the kidneys.

Choice E reason:

Immune system functioning decreases, and risk of cancer increases. Chronic stress can suppress the immune system, making the body more susceptible to infections and diseases. Prolonged immune suppression can also increase the risk of cancer as the body’s ability to detect and destroy abnormal cells is compromised.

Choice F reason:

Risk of depression, autoimmune disorders, and heart disease increases. Long-term stress is linked to an increased risk of depression and other mental health disorders due to the continuous release of stress hormones affecting brain function. It can also trigger autoimmune disorders by causing chronic inflammation and dysregulation of the immune system. Additionally, the persistent high levels of stress hormonees can lead to heart disease by promoting hypertension and other cardiovascular issues.

Choice A Reason:
This statement reflects an attempt to de-escalate a potential conflict by taking responsibility for an action that may have caused distress. However, it does not directly invite dialogue or understanding between family members. Effective communication in family therapy aims to foster open and empathetic dialogue, where members feel heard and understood.

Choice B Reason:
Asking for clarification on emotions connected to specific events is a hallmark of effective communication. This statement opens the door for the family member to share their feelings and for others to understand the perspective behind the emotions. It encourages a non-confrontational exchange of thoughts and feelings, which is essential in family therapy to promote healing and understanding.

Choice C Reason:
This statement is an example of a threat, which can lead to increased tension and conflict within the family. It is counterproductive to the goals of family therapy, which include improving communication and resolving conflicts in a constructive manner. Effective communication should be free of coercion and intimidation.

Choice D Reason:
While this statement may reflect a feeling or concern within the family dynamic, it is framed as an accusation rather than an invitation to discuss the behavior or its impact. Effective communication involves expressing one's own feelings and needs without making judgments about others' actions.