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Question

Difficulty: MediumGrief and Loss

A home health licensed practical nurse (LPN) is visiting a client who is recovering from a recent stroke. The client's spouse of 40 years died unexpectedly two weeks ago. When the nurse arrives, the client yells, "Get out! I do not need your help or anyone else's!" Which response by the nurse is the most appropriate?

  1. A
    You are going through the anger stage of grief right now, which is completely expected.
  2. You have experienced a tremendous loss. I will just sit here quietly with you.Answer
  3. C
    Why are you directing your anger at me when I am only here to provide care?
  4. D
    Getting this upset is dangerous for your blood pressure and could cause another stroke.

Answer

The most appropriate response is to acknowledge the magnitude of the client's loss and offer a supportive, silent presence.
The correct response utilizes the therapeutic communication techniques of acknowledging the client's feelings and 'offering self.' Anger and displacement are normal manifestations of acute grief. By validating the magnitude of the loss and offering a quiet, non-judgmental presence, the nurse provides a safe environment for the client to process their emotions without feeling pressured, abandoned, or confronted.

Step-by-Step Solution

1
Analyze the underlying cause of the client's behavior.
The client's hostility is identified as a normal manifestation of acute grief related to the sudden death of their spouse, rather than true refusal of care or a personal attack.
Anger is a common emotion during the grieving process and is frequently displaced onto healthcare providers or surviving family members.
2
Select the nursing response that utilizes therapeutic communication techniques.
The nurse chooses to acknowledge the client's loss and offer a quiet, non-judgmental presence.
Therapeutic communication prioritizes the client's emotional safety. 'Offering self' provides support and validates the client's current emotional state without escalating the conflict.

Key Concept

Therapeutic Communication in Acute Grief
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Topics

Grief and Loss

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