The health care provider prescribes haloperidol 10 mg for a client with severe psychosis but the client refuses the medication. Which nursing action is appropriate?

Accept the client's decision and continue to maintain safety.

Obtain a discharge order for nonadherence to the medication regimen.

Restrain the client and give the medication intramuscularly.

Inform the client that refusing the medication means not getting any better.

Answer and Explanation

The Correct Answer is A

Every individual has the right to refuse medical treatment, including medications, as long as they are competent to make that decision. It is essential to respect the client's autonomy and right to make decisions about their own health care. When a client refuses medication, the nurse should document the refusal, inform the healthcare provider, and explore the reasons behind the refusal if possible.

The other options are not appropriate for the following reasons:

B- Obtaining a discharge order for nonadherence: While it is essential to address nonadherence to medication, discharging the client solely for refusing the medication may not be the best course of action. Instead, the nurse should work collaboratively with the healthcare team to address the client's concerns and explore alternative treatment options.

C- Restraining the client and giving the medication intramuscularly: Restraints should only be used as a last resort when a client presents an imminent danger to themselves or others, and it must be done in accordance with facility policies and legal regulations. Using restraints to administer medication against a client's will is a violation of their rights and is not an appropriate response to medication refusal.

D-Informing the client that refusing the medication means not getting any better: This response may be seen as coercive and manipulative. It is not ethical to use fear or guilt to persuade a client to take medication against their will. Instead, the nurse should provide information about the potential benefits and risks of the medication and address the client's concerns or fears about the treatment. Ultimately, the decision to take the medication should be left to the client after they have been fully informed about their options.

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Correct Answer is A

Explanation

The safety of both the client and others is the top priority in this situation. The client's aggressive behavior poses a significant risk, and immediate action is necessary. Calling for an emergency response from trained personnel, such as security or other staff members experienced in handling aggressive behavior, can help ensure the situation is properly managed and de-escalated in a safe manner.

Option B may not be appropriate in this situation, as trying to engage the client in verbal expression of anger while they are in an agitated and aggressive state can potentially escalate the situation further.

Option C is not recommended, as approaching the client in a confrontational manner may further escalate their anger and aggression.

Option D, while it may be beneficial in a different context and when the client is in a more stable state, is not appropriate when the client is actively engaged in aggressive behavior. The focus at this moment should be on ensuring the immediate safety of everyone involved.

A. Anticipatory grief B. Disenfranchised grief C. Complicated grief D. Absence of grief

Correct Answer is A

Explanation

Anticipatory grief refers to the emotional response and mourning that occurs before an actual loss or death. In this case, the client is grieving the loss of the pregnancy due to the decision to have an elective abortion. The grief arises from the anticipation of not being able to have the child at this time, even though they may want to have children in the future.

B- Disenfranchised grief: Disenfranchised grief refers to a type of grief that is not openly acknowledged or socially validated. It occurs when a person experiences a loss that is not commonly recognized or is not socially accepted. In this case, the client's grief is not disenfranchised because the loss of an unintended pregnancy through elective abortion is openly acknowledged and socially accepted.

C- Complicated grief: Complicated grief, also known as prolonged grief or unresolved grief, occurs when a person experiences intense, prolonged, or incapacitating grief that doesn't seem to improve over time. It can be a result of traumatic loss or when the person has difficulty accepting the reality of the loss. The client's grief over the elective abortion does not necessarily indicate complicated grief since it is a normal response to the loss of the pregnancy.

D- Absence of grief: Absence of grief would mean that the client is not experiencing any emotional response or sorrow after the elective abortion, which is unlikely in this situation. The client is crying and expressing emotions, indicating the presence of grief.

In summary, the most appropriate choice for the client's experience is "Anticipatory grief" since the client is grieving the loss of the pregnancy before it actually occurred due to the timing of the pregnancy not aligning with their plans.

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