A nurse is reviewing the medical histories of four clients.
Which of the following clients may develop extrapyramidal symptoms from medication therapy?

The correct answer(s) is/are:

C. Telling his parents that he doesn't want to talk about the suicide attempt.

Rationale:

Choice A: Planning to give his Xbox console to his best friend.

While giving away possessions can be a sign of hopelessness or detachment, in this case, it could also be interpreted as a gesture of closure or wanting to leave something meaningful behind for a loved one. It doesn't necessarily indicate ongoing suicidal intent.

Choice B: Stating that he wants to be with his peers more than with his parents.

This desire for social connection and autonomy is actually a positive sign in a post-suicidal attempt adolescent. It demonstrates a shift towards seeking support from outside the family unit and engaging with life beyond the immediate aftermath of the attempt.

Choice C: Telling his parents that he doesn't want to talk about the suicide attempt. This reluctance to discuss the attempt can be a red flag for several reasons:

Avoidance: Suppressing or avoiding thoughts and feelings related to the attempt can indicate a struggle to cope with the emotional trauma and potentially harboring lingering suicidal ideation.

Isolation: Withdrawing from open communication about the event can isolate the adolescent further, hindering the support system and potentially increasing the risk of reattempt.

Underlying distress: The inability to talk about the event may suggest unresolved emotional distress, unresolved conflicts, or ongoing stressors that could contribute to suicidal thoughts.

Therefore, while not wanting to talk doesn't definitively signify current suicidal intent, it warrants further exploration by the nurse to understand the underlying reasons behind the avoidance and ensure appropriate support and safety measures are in place.

Choice D: Preferring to eat his meals while watching TV.

This behavior is relatively neutral and doesn't directly suggest ongoing suicidal intent. While it might indicate depression or low motivation, it's not a specific indicator of suicide risk.

Conclusion:

Based on the rationale above, "telling his parents that he doesn't want to talk about the suicide attempt" (Choice C) is the most concerning behavior that suggests the adolescent might still have suicidal intent. It's crucial for the nurse to address this reluctance with empathy and understanding, exploring the underlying reasons and ensuring continued monitoring and support for the adolescent.

Choice A rationale:

Judgmental and challenging: Asking "Why did you feel you needed to do that at this time?" implies that the parents' decision may not have been the best one. It puts them on the defensive and could make them feel like they need to justify their actions.

Not empathetic: This response does not acknowledge the parents' feelings of sadness, disappointment, or loss. It focuses on the decision itself rather than on the emotional impact it has had on the family.

Not supportive: The nurse's role is to provide support and understanding, not to the parents' decisions. This response does not offer any emotional support or validation.

Choice B rationale:

Empathetic and validating: This response acknowledges the parents' feelings and shows that the nurse understands how difficult it must have been to cancel their son's baseball registration. It also validates their decision, which can be helpful in coping with difficult situations.

Opens up communication: By expressing empathy, the nurse encourages the parents to share their feelings and experiences. This can help them to process their emotions and feel more supported.

Facilitates understanding: By recognizing the parents' frustration, the nurse can better understand their perspective and provide more tailored support. This can help to strengthen the nurse-client relationship and promote trust.

Choice C rationale:

False hope: While it is possible that the child's condition could improve, it is not realistic to offer false hope to the parents. This response could make it more difficult for them to accept the reality of their child's illness and could lead to disappointment and frustration in the future.

Dismissive of feelings: This response does not acknowledge the parents' current feelings of sadness and loss. It focuses on the future, which can be overwhelming and anxiety-provoking for parents who are facing a terminal illness.

Choice D rationale:

Irrelevant and insensitive: The dangers of baseball are not relevant to the parents' decision to cancel their son's registration. This response is dismissive of their feelings and does not offer any support or understanding.

Potentially offensive: This response could be interpreted as suggesting that the parents are being overprotective or that they are making a decision based on fear rather than on their child's best interests.