A nurse is providing care to a client with suicidal ideation. Select all the interventions that the nurse should include in the implementation phase of the client's care.

Choice A rationale:

The nursing diagnosis "Impaired coping" signifies that the client is experiencing difficulty in dealing with stressors and challenges. While it's true that impaired coping can contribute to various negative outcomes, the most critical concern when dealing with a client diagnosed with impaired coping and suicidal ideation is the risk of self-inflicted harm, which aligns with choice A. Clients with impaired coping and suicidal ideation are at a heightened risk for engaging in self-destructive behaviors, including attempts at self-inflicted, life-threatening injury. This choice is the most relevant and urgent, as it directly addresses the potential harm the client may cause to themselves due to their impaired coping skills.

Choice B rationale:

Although feelings of aloneness can contribute to psychological distress and could potentially be relevant to the client's situation, choice B does not directly address the immediate risk of self-inflicted injury associated with impaired coping and suicidal ideation. The focus in this case should be on the client's safety and preventing self-harm.

Choice C rationale:

This choice accurately describes one aspect of impaired coping but does not specifically address the increased risk of self-inflicted harm or the severity of the situation presented in the question. While impaired coping does involve the inability to use appropriate skills to manage stressors, the urgency of addressing the immediate risk of self-inflicted injury takes precedence in this scenario.

Choice D rationale:

Negative self-evaluation may contribute to impaired coping, but the question specifically relates to the client's risk for self-inflicted, life-threatening injury. While negative self-evaluation could be part of the client's overall presentation, it's not the most direct or urgent concern in this situation.

Choice A rationale:

Active listening. Active listening is an important communication skill that involves attentively hearing and interpreting what the patient is saying. However, it doesn't specifically address the aspect of acknowledging the patient's feelings and thoughts as real and understandable without agreeing or disagreeing.

Choice B rationale:

Empowerment. Empowerment refers to the process of enabling and supporting patients to take control of their own health and make informed decisions. While this is an essential aspect of patient care, it doesn't directly address the skill of acknowledging the patient's feelings and thoughts without expressing agreement or disagreement.

Choice C rationale:

Validation. Validation involves recognizing and accepting the patient's feelings and thoughts as valid, even if you don't share the same perspective. It shows empathy and understanding without passing judgment. In the context of a patient with suicidal ideation, validation is crucial as it helps build trust and rapport, creating an environment where the patient feels heard and supported.

Choice D rationale:

Open-ended questions. Open-ended questions are inquiries that can't be answered with a simple "yes" or "no" and encourage patients to provide more detailed responses. While they are valuable for eliciting information, they don't specifically address the act of acknowledging the patient's feelings and thoughts as real and understandable without taking a stance.