A nurse is planning care for a client who has adjustment disorder following a traumatic below-the-knee amputation. Which of the following actions should the nurse include?

Respect the client's need for social isolation.

Encourage the client's family members to perform the client's ADLS.

Discourage the client from talking about activities he did prior to the amputation.

Determine the client's stage of grief.

Answer and Explanation

The Correct Answer is D

A. Respect the client's need for social isolation:
While it's important to respect the client's need for moments of solitude and privacy, complete social isolation can lead to feelings of loneliness and exacerbate depressive symptoms. Balance is key; the nurse should encourage social interactions and support while respecting the client's need for personal space and alone time.

B. Encourage the client's family members to perform the client's ADLs:
Encouraging the client's family members to take over all activities of daily living (ADLs) can strip the client of their independence and self-efficacy. Instead, the nurse should support the client in actively participating in their self-care activities to the extent they are able. This promotes a sense of control and empowerment during a challenging time.

C. Discourage the client from talking about activities he did prior to the amputation:
Discouraging the client from discussing their life before the amputation can hinder the process of accepting the loss. Allowing the client to talk about their past experiences, activities, and memories can be therapeutic. It helps them process the grief associated with the amputation and allows for a healthy expression of emotions.

D. Determine the client's stage of grief:
Understanding the client's stage of grief is crucial. Grieving is a natural and individual process, and different people progress through stages like denial, anger, bargaining, depression, and acceptance at their own pace. By identifying the client's current stage of grief, the nurse can offer tailored support and interventions, ensuring the client's emotional needs are met effectively.

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Correct Answer is B

Explanation

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.

A. Initiates social interactions with caregivers B. Meets own needs without manipulating others C. Changes behavior as a result of peer pressure D. Acknowledges that his delusions are not real

Correct Answer is A

Explanation

A. Initiates social interactions with caregivers:One of the key goals for adolescents with autism spectrum disorder (ASD) is to improve social skills and interactions. Encouraging the adolescent to initiate social interactions is a positive and realistic outcome that promotes social development and enhances communication skills.

B. Meets own needs without manipulating others:While fostering independence and self-advocacy is important, adolescents with ASD may struggle with understanding social cues and may not manipulate others in a typical sense. This outcome may not be as relevant or achievable for the individual with ASD.

C. Changes behavior as a result of peer pressure:Adolescents with ASD may have difficulty understanding and responding to peer pressure in the same way as their neurotypical peers. This outcome may not be appropriate or realistic for someone with ASD, as it can lead to increased anxiety or discomfort.

D. Acknowledges that his delusions are not real:This outcome is more relevant to conditions such as schizophrenia or severe psychotic disorders, rather than ASD. Adolescents with autism may experience different cognitive challenges but generally do not have delusions in the way that individuals with psychotic disorders do.

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