A nurse in a mental health facility is assessing a client.

• The client has a medical history of major depressive disorder for 20 years, anxiety disorder, suicide ideation during teenage years, and psychotherapy for the past 10 years with a therapist.
• The client's mother committed suicide when the client was 25 years of age, and the father died of heart disease 10 years ago.
• The client has a history of alcohol misuse, attended in-patient rehabilitation 4 years ago with no alcohol use since that time.
• The nurse notes indicate good physical health with no reported morbidities.

For each client assessment finding, specify if the finding is a potential risk for suicide or a protective factor against suicide.

Choice A rationale:

Dismissive and unsupportive: This response discounts the client's son's feelings of guilt and obligation toward their parent. It also implies that the client's son's presence is not valuable, which could further increase their distress.

Undermines the client's son's role as a caregiver: It suggests that the client's son has no responsibilities or ability to contribute to their parent's care, which could diminish their sense of agency and potentially lead to resentment or regret.

Fails to address the underlying emotions: It does not acknowledge the client's son's internal conflict and emotional turmoil, which is essential for providing effective support.

Choice C rationale:

Offers a practical solution, but may not address the core issue: While calling the children could provide temporary reassurance, it may not fully alleviate the client's son's feelings of guilt or anxiety about leaving their parent.

May not be feasible or sufficient: The client's son may need more than a phone call to feel comfortable leaving, and they may not be able to reach their children immediately.

Could be perceived as dismissive: It could suggest that the nurse is minimizing the client's son's concerns and not fully understanding their emotional needs.

Choice D rationale:

Reassuring, but may not address the client's son's guilt: While it provides assurance about the client's care, it does not directly acknowledge or validate the client's son's feelings of guilt or obligation.

Focuses on the client's care, but not the client's son's needs: It prioritizes the physical care of the client, but may overlook the emotional needs of the client's son, who is also a primary stakeholder in the situation.

May not be enough to alleviate the client's son's concerns: The client's son may still feel responsible for their parent's well- being, even with reassurance from the nurse.

Choice B rationale:

Empathetic and validates the client's son's feelings: It directly acknowledges the client's son's conflicting emotions and demonstrates understanding of their difficult situation.

Promotes self-reflection and exploration: It encourages the client's son to further express their feelings and explore their options, which can lead to greater clarity and self-awareness.

Facilitates decision-making: It helps the client's son to weigh their priorities and make a decision that aligns with their values and responsibilities, ultimately empowering them to take action.

Strengthens the therapeutic relationship: It demonstrates the nurse's ability to connect with the client's son on an emotional level, building trust and rapport.

To calculate the amount of fluoxetine to administer, we can use the following steps:

Step 1: Identify the desired dose, which is 40 mg.

Step 2: Identify the available dose, which is 20 mg/5 mL.

Step 3: Set up the equation to solve for the unknown, which is the volume in mL. The equation is (Desired Dose ÷ Available Dose) × Volume = Volume to Administer.

Step 4: Substitute the known values into the equation: (40 mg ÷ 20 mg) × 5 mL = Volume to Administer. Step 5: Solve the equation: 2 × 5 mL = 10 mL.

So, the nurse should administer 10 mL of fluoxetine.