A nurse is providing discharge teaching for a patient who had a seizure disorder and is prescribed phenytoin (Dilantin).

Which of the following instructions should the nurse include?

(Select all that apply.).

The correct answer is C.

Ego integrity vs despair.

According to Erikson’s psychosocial theory, older adults face the challenge of looking back on their lives and evaluating their accomplishments and failures.

If they feel satisfied with their life course, they achieve a sense of ego integrity, which is a feeling of wholeness and coherence.

If they feel regretful or dissatisfied, they experience despair, which is a sense of hopelessness and bitterness.

Choice A is wrong because trust vs mistrust is the first stage of Erikson’s theory, which occurs in infancy.

It involves developing a basic sense of trust in oneself and others based on the quality of caregiving.

Choice B is wrong because generativity vs stagnation is the seventh stage of Erikson’s theory, which occurs in middle adulthood.

It involves contributing to society and the next generation through work, parenting, or other activities.

Choice D is wrong because identity vs role confusion is the fifth stage of Erikson’s theory, which occurs in adolescence.

It involves developing a stable and coherent sense of self and one’s role in society.

Normal ranges for Erikson’s stages are:.

• Trust vs mistrust: birth to 18 months.

• Autonomy vs shame and doubt: 18 months to 3 years.

• Initiative vs guilt: 3 to 6 years.

• Industry vs inferiority: 6 to 12 years.

• Identity vs role confusion: 12 to 18 years.

• Intimacy vs isolation: 18 to 40 years.

• Generativity vs stagnation: 40 to 65 years.

• Ego integrity vs despair: 65 years and older.

The correct answer is D.

“Social interaction can help me avoid stress and anxiety.” This statement indicates a need for further teaching because social interaction does not necessarily help older adults avoid stress and anxiety.

In fact, some social situations may cause or increase stress and anxiety for some people, especially if they are negative, unpleasant, or conflictual.

Therefore, the nurse should explain to the client that social interaction can help them cope with stress and anxiety, but not avoid them altogether.

Choice A is correct because social interaction can help lower blood pressure and cholesterol levels by reducing the effects of stress hormones and promoting physical activity.

Choice B is correct because social interaction can help boost the immune system by enhancing positive emotions, increasing antibody production, and reducing inflammation.

Choice C is correct because social interaction can help improve memory and learning ability by stimulating brain regions involved in cognition, communication, and social perception.

Normal ranges for blood pressure are less than 120/80 mmHg for adults, and normal ranges for cholesterol are less than 200 mg/dL for total cholesterol, less than 100 mg/dL for LDL cholesterol, and more than 40 mg/dL for HDL cholesterol.