A nurse is caring for an adolescent on an inpatient mental health unit who is undergoing detoxification for a substance use disorder. He tells the nurse that he first began using illicit drugs when his parents wouldn't allow him to get a tattoo. Which of the following defense mechanisms is the client demonstrating?

Cognitive reframing involves changing negative or unhelpful thought patterns into more positive and constructive ones. By learning to change negative thoughts into positive statements, the client is actively engaging in cognitive reframing. This process helps the client challenge and reframe negative thoughts, replacing them with more positive and adaptive thoughts. By doing so, the client can reduce stress, improve their mood, and approach challenging situations with a more positive mindset. This technique is an effective way to cope with stress and promote emotional well-being.

Incorrect:

A. The client trains his mind to relax by using deep inner resources. This choice refers to relaxation techniques, which can be helpful for stress reduction but are not specifically related to cognitive reframing. Cognitive reframing focuses on changing thought patterns rather than relaxation techniques.

B. The client learns the source of his stress by writing down daily events. While identifying the source of stress can be an important step in stress management, it is not specific to cognitive reframing. Cognitive reframing involves challenging and changing negative thoughts, rather than solely focusing on identifying stressors.

C. The client imagines being in a quiet, relaxing environment. This choice refers to visualization or guided imagery techniques, which can also be helpful for relaxation but are not specifically related to cognitive reframing. Cognitive reframing involves changing thoughts, beliefs, and interpretations, rather than focusing on imagining specific environments.

From the given information, the nurse should include the following interventions in the plan of care for the client with dementia:
● Obtain client's weight weekly: Regular weight monitoring helps assess the client's nutritional status and detect any significant changes that may require intervention.
● Offer the client finger foods for meals: Finger foods can be easier for the client to handle and consume independently, promoting independence and self-feeding.
● Encourage the client to take deep breaths when feeling agitated: Deep breathing exercises can help the client manage their agitation and promote relaxation.
● Assess client's memory every shift: Regular assessment of the client's memory allows for monitoring any changes or decline, which helps in planning appropriate interventions and providing necessary support.
The following interventions should be avoided:

● Speak loudly when addressing the client: Speaking loudly may cause confusion or agitation in the client. Instead, it is recommended to use a calm and reassuring tone of voice.
● Give long tasks at a time to the client: Clients with dementia often have difficulty with concentration and memory. Providing long tasks may overwhelm them and contribute to their frustration. Breaking tasks into smaller, manageable steps is more appropriate.

● Turn the client's TV on at night when they are unable to sleep: It is generally recommended to create a quiet and calming environment for sleep. The TV may interfere with the client's sleep and contribute to increased agitation or confusion.