A nurse is reinforcing discharge teaching with a client who has borderline personality disorder. The client reports being a single parent caring for two toddlers. Which of the following actions should the nurse take?

A. Splitting is a defense mechanism commonly used by clients with borderline personality disorder. It involves viewing people or situations as entirely good or entirely bad, leading to rapidly shifting opinions and emotional reactions. This black-and-white thinking can create division among healthcare providers, as the client may idealize one staff member while devaluing another, causing conflict within the team.
B. Reaction formation occurs when a person expresses the opposite of their true feelings, often due to discomfort with their actual emotions. While seen in some personality disorders, it is not a hallmark feature of borderline personality disorder and does not typically contribute to team division.
C. Denial involves refusing to acknowledge reality or facts that cause distress. Though common in various mental health conditions, it does not specifically create division among healthcare providers in the way splitting does. Clients with borderline personality disorder may use denial, but it is not their primary defense mechanism.
D. Regression is a defense mechanism where an individual reverts to earlier developmental behaviors in response to stress. While it can be seen in borderline personality disorder, it does not typically lead to splitting within the healthcare team, as it primarily affects the client’s own coping mechanisms rather than interpersonal dynamics.

A. The blinds in the client's room will need to stay closed to prevent overstimulation. Keeping the blinds closed is not a standard suicide prevention measure. While reducing overstimulation may be helpful for some mental health conditions, suicide prevention focuses more on removing means of self-harm, increasing supervision, and providing therapeutic interventions.
B. Family members should be encouraged to look up the warning signs of suicide. While educating family members about suicide warning signs is beneficial, simply encouraging them to look up the information is insufficient. The nurse should provide direct education and resources to ensure they recognize signs of suicidal ideation and know how to respond appropriately.
C. The client can eat their meal alone in their room. Allowing a suicidal client to eat alone increases the risk of self-harm, as food-related items (such as utensils, plastic bags, or containers) could be misused. Clients at risk for suicide should be supervised during meals to ensure their safety.
D. All sharp objects should be removed from the client's room. Removing sharp objects is a critical component of suicide prevention in inpatient settings. Limiting access to potential means of self-harm, including sharp items, cords, belts, and other dangerous objects, helps reduce the risk of suicide attempts.