A nurse is making a home visit to a client who has Alzheimer's disease and the client's partner. Which of the following observations indicates to the nurse that the partner is experiencing caregiver role strain?

A) Maturational crisis:

This type of crisis arises from normal life transitions, such as entering a new stage of development (adolescence, midlife crisis, etc.). It involves a struggle to adapt to new roles and responsibilities. The client's situation does involve a life transition due to the death of his wife, but the sudden nature of the event and the resulting distress suggest a situational crisis.

B) Adventitious crisis:

Adventitious crises are caused by extraordinary events that are external to the individual's usual experience, such as natural disasters, accidents, or crimes. While the sudden death of the client's wife is an unexpected and tragic event, it's not an adventitious crisis because it involves personal loss rather than a large-scale or external event.

C) Developmental crisis:

Developmental crises are associated with specific stages of life and the challenges and changes that come with them. This crisis doesn't seem to fit the developmental category as it is more tied to the specific event of the wife's sudden death.

D) Situational crisis

Explanation:

A situational crisis is a type of crisis that arises from a specific event or situation that disrupts an individual's normal functioning and coping abilities. In this case, the sudden death of the client's wife is the triggering event that has led to his feeling paralyzed and overwhelmed in his ability to cope with work and family responsibilities. Situational crises are often unexpected and can lead to a temporary state of disorganization and distress.

A. Determining if the client has psychotic thinking.

Explanation: The highest priority assessment in this situation is to determine if the client has psychotic thinking. Psychotic thinking can indicate a severe mental health condition that requires immediate attention and intervention. If the client is experiencing psychotic symptoms, they might be at risk of harming themselves or others. Identifying and addressing psychotic thinking is crucial to ensure the safety and well-being of the client and those around them.

B. Asking the client to identify the cause of the crisis.

While understanding the cause of the crisis is important for providing appropriate care, it is not the highest priority. Psychotic thinking or risk of harm takes precedence over understanding the cause.

C. Identifying the client's coping skills.

Coping skills are important for managing the crisis and promoting the client's well-being, but assessing for psychotic thinking and immediate safety concerns comes before evaluating coping skills.

D. Identifying the client's support systems.

Support systems are valuable for the client's overall recovery, but they are not as time-sensitive as assessing for psychotic thinking or imminent safety risks. Identifying support systems can come after addressing the immediate concerns.