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Difficulty: MediumGrief and Loss

A practical nurse (PN) at a community health clinic is speaking with a 24-year-old client whose best friend died suddenly in a motor vehicle crash three days ago. The client is pacing, visibly agitated, and states, "This cannot be happening. I just talked to them on Tuesday!" Which of the following statements by the PN are appropriate? Select all that apply.

  1. This is an incredibly difficult situation. I am here for you.Answer
  2. It sounds like you are feeling a deep sense of shock right now.Answer
  3. C
    You must be strong; your friend would want you to keep moving forward.
  4. D
    Why do you think you are pacing around the room so much?
  5. Take your time. You can share whatever you are feeling when you are ready.Answer
  6. F
    You are just in the denial stage; the anger will come next.

Answer

The therapeutic responses involve offering self, validating the client's feelings of shock, and allowing the client to share at their own pace.
The correct statements utilize foundational therapeutic communication techniques: offering self, reflecting/validating emotions, and providing broad openings. During the acute phase of sudden grief, clients often experience intense shock and agitation. The nurse's role is to provide a safe, non-judgmental environment that allows the client to process their reality without feeling pressured or invalidated.

Step-by-Step Solution

1
Analyze the client's clinical presentation.
The client is experiencing acute grief, specifically shock and denial, following a sudden, traumatic loss three days ago.
Understanding the timeline and nature of the loss helps determine the most appropriate therapeutic communication strategies.
2
Evaluate each nursing response against therapeutic communication principles.
Responses that offer self, reflect feelings, and provide broad openings are therapeutic. Responses that give advice, ask "why", or enforce rigid stages of grief are non-therapeutic.
The LPN/LVN must use communication techniques that facilitate expression of grief rather than blocking it.
3
Select the statements that apply therapeutic techniques.
The statements validating the shock, offering presence, and giving the client time are correct.
These actions directly support the client's psychosocial integrity during an acute crisis.

Key Concept

Therapeutic Communication in Acute Grief
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Topics

Grief and Loss

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