A nurse in an acute care mental health facility is creating a plan of care for a newly admitted client. Which of the following interventions should the nurse plan to include in the working phase of the nurse-client relationship?

A. The nurse maintains confidentiality unless the client's safety is compromised:
Explanation: Maintaining confidentiality is a fundamental principle in nursing practice. Nurses are ethically and legally obligated to keep client information confidential, ensuring that the client's privacy is respected. Confidentiality builds trust between the nurse and the client, encouraging open communication. However, confidentiality can be breached if the client's safety is at risk, such as if they express suicidal or homicidal thoughts, indicating the need for intervention to ensure their well-being.

B. The nurse seeks to spend extra time specifically with the client each day:
Explanation: While it's important for nurses to spend adequate time with each client, seeking to spend extra time specifically with one client may create imbalances in care distribution. Nurses should strive to provide equitable care to all clients, addressing their needs based on assessments and care plans. Special attention to one client could lead to feelings of favoritism or neglect among other clients, affecting the therapeutic environment.

C. The client sees the nurse as an authority figure:
Explanation: Clients often view nurses as authority figures due to their expertise and role in healthcare. This perception can facilitate a therapeutic relationship, as clients may trust the nurse's guidance and care. However, this should be balanced with empathy and understanding to create a supportive and therapeutic environment.

D. The client regards the nurse as a friend:
Explanation: While a therapeutic nurse-client relationship aims for trust and rapport, it is not a friendship. The nurse maintains professional boundaries to provide objective care without personal bias. Friendship implies a level of personal involvement that can compromise the nurse's ability to make objective clinical decisions. A therapeutic relationship is built on trust, respect, empathy, and clear professional boundaries.

A. Contact a close relative of the client to discuss the discharge plan:
Involving close relatives or a support system can be beneficial for the client's recovery. However, it's crucial to respect the client's confidentiality and privacy. In some cases, clients might not want their relatives involved or might not have a supportive family environment, so this option should be approached cautiously and with the client's consent.

B. Refer the client to a self-help group:
This is a highly recommended action. Self-help groups like Alcoholics Anonymous (AA) provide a supportive environment where individuals with alcohol use disorder can share their experiences and coping strategies. These groups can significantly contribute to maintaining sobriety after rehabilitation.

C. Request a discharge prescription for buprenorphine for the client:
Buprenorphine is typically used to treat opioid use disorder, not alcohol use disorder. Medications like disulfiram, naltrexone, and acamprosate are more commonly prescribed to help individuals manage alcohol cravings and maintain abstinence. However, the choice of medication should be individualized and determined by a healthcare provider based on the client's specific needs and medical history.

D. Teach the client to practice systematic desensitization:
Systematic desensitization is a therapeutic technique used to treat phobias and anxieties by gradually exposing individuals to their fears in a controlled and safe manner. While it can be helpful for addressing anxiety-related issues, it's not a standard treatment for alcohol use disorder. Therapeutic interventions for alcohol use disorder often focus on behavioral therapies, counseling, and support groups.