A nurse is assisting in the care of a client who presents to the emergency department.

Exhibits

A nurse is reviewing the client's medical record. Which of the following findings indicate the need for further evaluation?

Explanation:

Displacement is a defense mechanism in which an individual redirect their emotions or impulses from their original target to a less threatening or safer target. In this scenario, the client yells at the nurse when medication changes are prescribed by the provider. The client may be feeling angry or frustrated about the medication changes but is unable to express those emotions directly towards the provider. Instead, the client displaces those feelings onto the nurse, who may be seen as a safer or more accessible target. The yelling behavior directed at the nurse is a way for the client to release and express their emotions indirectly.

Let's briefly discuss the other defense mechanisms mentioned:

A- Conversion: Conversion involves the expression of psychological distress or conflict through physical symptoms or ailments. It is not applicable in this scenario since the client's behavior does not involve physical symptoms.

B- Splitting: Splitting is a defense mechanism characterized by a black-and-white thinking pattern, where individuals perceive others or situations as all good or all bad. It does not directly apply in this scenario as the client's behavior is not indicative of splitting.

D- Sublimation: Sublimation is a defense mechanism in which an individual channel their unacceptable or potentially harmful impulses into socially acceptable outlets, such as creative or productive activities. It is not evident in this scenario as the client's behavior does not involve transforming the emotions into a more positive or socially acceptable form.

Chemotherapy treatments, which are used to treat cancer, can suppress the immune system and weaken the body's ability to respond to vaccines. As a result, receiving a live attenuated vaccine like the varicella immunization can pose a risk of severe complications for individuals undergoing chemotherapy. Therefore, it is contraindicated to administer the varicella vaccine in this case.

Medications for a cardiac anomaly, clear rhinorrhea, and two diarrhea stools in the last day are not contraindications for receiving a varicella immunization.

While medications for a cardiac anomaly and certain medical conditions may require special consideration or precautions when administering vaccines, they are not absolute contraindications for the varicella vaccine. The decision to administer the vaccine would depend on the individual's specific circumstances and the healthcare provider's assessment. Clear rhinorrhea (runny nose) and two diarrhea stools in the last day are considered minor illnesses and do not contraindicate the varicella vaccine. Generally, mild illnesses without fever or systemic symptoms do not pose a significant risk when receiving vaccines. However, it is always important to assess the overall health status of the individual and consult with a healthcare provider if there are concerns.