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Difficulty: HardEnd of Life Care

A practical nurse is caring for a client who recently received a terminal prognosis. The client's sibling pulls the nurse aside in the hallway and states, "Please promise me you will not mention hospice care to my sibling. If they hear that word, they will completely give up hope and stop fighting." Which response by the nurse is most therapeutic?

  1. It sounds like you are deeply concerned about your sibling's reaction. Tell me more about what you are feeling.Answer
  2. B
    Why do you believe that discussing hospice care will cause your sibling to give up hope?
  3. C
    I understand this is a difficult time, so I will ensure the staff avoids using that specific word.
  4. D
    Your sibling has the right to be informed about all available care options, so we must discuss it.

Answer

The most therapeutic response validates the sibling's distress using reflection and an open-ended statement, such as acknowledging their concern and asking them to tell the nurse more about what they are feeling.
The correct response utilizes therapeutic communication techniques by reflecting the sibling's feelings back to them and providing an open-ended prompt. This approach validates the family member's distress, builds trust, and allows them to safely explore their fears about the dying process without the nurse making inappropriate promises or arguing.

Step-by-Step Solution

1
Identify the core issue in the family member's statement.
The sibling is experiencing significant anticipatory fear and distress, which is leading them to request that vital information be withheld from the client.
Recognizing the underlying emotion is essential for selecting a response that addresses psychosocial needs rather than just reacting to the literal request.
2
Evaluate the response options against the principles of therapeutic communication.
Responses that contain 'why' questions, offer inappropriate promises to hide information, or rely on cold legal facts must be eliminated as they represent communication blocks.
Non-therapeutic communication blocks hinder the establishment of trust and fail to support the family member's emotional needs.
3
Select the option that best facilitates open communication and emotional support.
The option that reflects the sibling's concern and invites them to share more is identified as the correct response.
This approach validates the family member's feelings and keeps the lines of communication open, which is the priority in end-of-life psychosocial interventions.

Key Concept

Therapeutic Communication in End of Life Care
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Topics

End of Life Care

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