A nurse in a mental health clinic is assessing a client who has borderline personality disorder. Which of the following findings should the nurse expect?

Choice A Reason:
This response acknowledges the partner's feelings and validates their emotional experience. It shows empathy and understanding, which are crucial in providing support during the grieving process. By recognizing the difficulty of the partner's emotions, the nurse helps create a safe space for the partner to express their feelings. This approach aligns with therapeutic communication techniques that emphasize active listening and emotional validation.

Choice B Reason:
Telling the partner that they shouldn't feel guilty and that they took excellent care of their partner, while well-intentioned, may come across as dismissive of their feelings. Guilt is a common emotion in grief, and it is important to allow the partner to express and process these feelings rather than dismissing them. The nurse should focus on validating the partner's emotions and providing a supportive environment.

Choice C Reason:
Sharing personal experiences, such as saying "I felt the same way when my partner died," can sometimes be helpful, but it may also shift the focus away from the partner's feelings. The primary goal is to support the partner and validate their emotions. While it can be comforting to know that others have had similar experiences, the nurse should be cautious about making the conversation about their own experiences.

Choice D Reason:
Suggesting that the partner see a grief counselor is a practical recommendation, but it may not be the most immediate or supportive response. The partner is expressing their emotions in the moment, and the nurse's priority should be to provide empathetic support. Once the partner feels heard and validated, the nurse can gently suggest additional resources like grief counseling.

Choice A reason:
The statement "Promote decision making about care" is not appropriate for a client experiencing delirium. Delirium can cause confusion, disorientation, and impaired decision-making abilities. Encouraging the client to make decisions about their care may increase their anxiety and confusion.

Choice B reason:
The statement "Discourage visits from significant others" is not advisable. Visits from familiar people can provide comfort and reassurance to a client experiencing delirium. Isolation can exacerbate feelings of confusion and distress.

Choice C reason:
The statement "Provide environmental cues" is the correct response. Environmental cues, such as clocks, calendars, and familiar objects, can help orient the client and reduce confusion. Maintaining a consistent routine and minimizing environmental changes can also promote safety and comfort.

Choice D reason:
The statement "Apply physical restraints" is not recommended as a first-line intervention. Physical restraints can increase agitation and the risk of injury. They should only be used as a last resort when the client poses an immediate danger to themselves or others and when less restrictive measures have failed.