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Difficulty: HardTherapeutic Communication

An adult client is admitted to the surgical unit the evening before a scheduled total abdominal hysterectomy. The practical nurse observes the client pacing the hallway. The client suddenly stops and states, 'My sister had this exact procedure two years ago and ended up with a life-threatening infection. I should just get dressed and leave right now.' Which response by the practical nurse is the most therapeutic?

  1. A
    The hospital utilizes strict infection control measures to ensure that you will remain completely safe during your recovery.
  2. B
    Would you like to share more details about the specific type of infection your sister developed after her surgery?
  3. It sounds as though you are very frightened about the possibility of developing a severe complication from your surgery.Answer
  4. D
    What makes you believe that you will experience the exact same post-operative complication as your sister?

Answer

The most therapeutic response is the one that reflects and validates the client's underlying emotions: 'It sounds as though you are very frightened about the possibility of developing a severe complication from your surgery.'
The correct answer utilizes the therapeutic technique of reflection. By stating, 'It sounds as though you are very frightened...', the nurse accurately identifies the client's underlying emotion (fear) and content (surgical complication). This validates the client's feelings, demonstrates empathy, and encourages the client to verbalize their anxiety further, which is the necessary first step in de-escalating the situation.

Step-by-Step Solution

1
Analyze the client's statement and nonverbal behavior to identify the core emotion.
The pacing, loud speech, and threat to leave indicate severe acute anxiety and fear related to the upcoming surgery.
Accurate assessment of the client's emotional state is required before selecting a therapeutic communication technique.
2
Evaluate the options for therapeutic versus non-therapeutic communication techniques.
Defending the hospital, shifting focus to the sister, and challenging the client's logic are non-therapeutic blocks. Reflecting the client's fear is a therapeutic technique.
Therapeutic communication should focus on the client's current feelings, validate their concerns, and encourage further expression without judgment.
3
Select the response that best applies therapeutic reflection.
The option acknowledging the client is 'very frightened' directly addresses the emotional context of the situation.
Reflection demonstrates empathy, helps the client feel heard, and opens the door to de-escalation.

Key Concept

Therapeutic Communication - Reflecting and Validating Client Fears
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Topics

Therapeutic Communication

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