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Difficulty: MediumEnd of Life Care

A terminally ill client residing in a skilled nursing facility tells the practical nurse, "I have decided to stop all treatments. I am so tired, but I haven't told my son yet because I know he will be furious." Which of the following responses by the nurse is the most therapeutic?

  1. It sounds like you are worried about how your son will react to your decision.Answer
  2. B
    Why do you think your son will be furious about a medical choice that is yours to make?
  3. C
    You need to tell him immediately so he can properly progress through the typical stages of grief.
  4. D
    Do not worry; I am sure he will support you once he realizes how exhausted you feel.

Answer

The most therapeutic response is to reflect the client's feelings by stating, "It sounds like you are worried about how your son will react to your decision."
The correct response utilizes reflection, an active listening technique that acknowledges the client's emotional state. This validates their anxiety and creates a safe space for them to elaborate on their feelings without feeling pressured or judged.

Step-by-Step Solution

1
Analyze the client's statement to identify the core emotion or concern.
The client is expressing fear and anxiety about their son's potential anger regarding the decision to stop treatment.
Understanding the underlying emotion is essential for selecting a therapeutic response.
2
Evaluate the nursing responses against established therapeutic communication principles.
Reflecting the client's stated concern validates their feelings, whereas asking 'why', giving advice, or offering false reassurance are communication blocks.
The practical nurse must facilitate open expression of feelings without judgment or unwarranted guarantees.

Key Concept

Therapeutic Communication in End of Life Care
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Topics

End of Life Care

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