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Difficulty: EasyGrief and Loss

While completing morning rounds on a maternity unit, a practical nurse (PN) observes a client who had a stillbirth the previous day. The client is holding a baby blanket and weeping silently. Which of the following actions is the most appropriate for the PN to take first?

  1. Remain with the client in silence and provide a supportive presence.Answer
  2. B
    Reassure the client by stating, "You are still young and can have other children."
  3. C
    Ask the client, "Why do you think you are having such a hard time today?"
  4. D
    Encourage the client to turn on the television to provide a distraction from the grief.

Answer

The most appropriate action is to remain with the client in silence and provide a supportive presence.
When a client is experiencing acute grief, such as after a stillbirth, offering self and utilizing silence are powerful therapeutic communication techniques. Remaining present with the client conveys empathy, compassion, and acceptance of their feelings without forcing them to talk before they are ready.

Step-by-Step Solution

1
Analyze the client's current emotional state.
The client is experiencing acute grief following a stillbirth and is weeping silently.
Understanding the immediate emotional context is necessary to select a therapeutic response.
2
Evaluate the proposed nursing actions against therapeutic communication principles.
Silence and offering self are therapeutic. Minimizing the loss, asking 'why', and providing distractions are non-therapeutic communication blocks.
The PN must avoid responses that invalidate or dismiss the client's grief.

Key Concept

Therapeutic Communication in Acute Grief
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Topics

Grief and Loss

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