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Difficulty: HardGrief and Loss

At an outpatient community clinic, a licensed practical nurse (LPN) is collecting data from a 45-year-old client whose spouse died in a work-related accident 15 months ago. Which findings indicate the client is potentially experiencing prolonged grief disorder and require immediate reporting to the registered nurse? Select all that apply.

  1. The client states, "My life has completely lost its meaning and I have no purpose without my partner."Answer
  2. B
    The client states, "I still find myself talking out loud to my spouse when I am doing chores around the house."
  3. The client becomes highly agitated and forbids anyone from moving or touching any of the deceased spouse's belongings.Answer
  4. D
    The client states, "Sometimes a specific song comes on the radio and I just break down crying."
  5. The client reports completely withdrawing from their long-term social circle because "seeing happy couples is unbearable."Answer
  6. F
    The client states, "I still feel flashes of intense anger at the company for not preventing the accident."

Answer

The findings that indicate prolonged grief disorder include the client's severe identity disruption (feeling life has lost meaning), extreme avoidance behaviors (forbidding anyone to touch belongings with high agitation), and persistent social impairment (withdrawing from friends).
Prolonged grief disorder is characterized by intense, disabling grief that persists longer than is typical (usually >12 months for adults). Key features include a pervasive sense of meaninglessness, extreme avoidance of reminders of the loss, and severe impairment in social or occupational functioning. Reporting these findings allows the RN to initiate psychiatric or advanced bereavement referrals.

Step-by-Step Solution

1
Analyze the time elapsed since the loss.
The client's spouse died 15 months ago.
Prolonged grief disorder is typically considered when intense, disabling grief symptoms persist beyond 12 months for adults.
2
Differentiate normal grieving behaviors from maladaptive symptoms.
Talking to the deceased, episodic crying, and flashes of anger are identified as normal continuing bonds and non-linear grief reactions.
Grief is highly individualized; clients do not 'finish' grieving, but rather integrate the loss. Reminders will naturally trigger emotional responses.
3
Identify manifestations of prolonged grief disorder (complicated grief).
Loss of purpose/identity, extreme avoidance/denial, and significant social isolation are identified as pathological.
These symptoms severely impair the client's ability to function and adapt to life without the deceased.
4
Select the findings that the LPN must report to the RN for further intervention.
The statements regarding a meaningless life, agitation over belongings, and unbearable social withdrawal are selected.
The LPN's role is to collect data, recognize abnormalities outside the expected grieving process, and collaborate with the RN for advanced care planning.

Key Concept

Distinguishing between expected, normal grief reactions (continuing bonds, episodic sorrow) and prolonged grief disorder (severe functional impairment, identity loss, and intense avoidance persisting > 12 months).
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Topics

Grief and Loss

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