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Difficulty: MediumTherapeutic Communication

An older adult client in an inpatient rehabilitation facility is recovering from a cerebrovascular accident that caused left-sided hemiparesis. During morning care, the client throws a washcloth on the floor and states, "I built houses for forty years with these hands. Now I cannot even wash my own face without dropping things." Which response by the practical nurse is the most therapeutic?

  1. It is very frustrating to lose the physical abilities you relied on for so long.Answer
  2. B
    You need to stay positive and focus on the fact that you survived such a severe stroke.
  3. C
    With consistent physical therapy, you will be back to washing your face independently in no time.
  4. D
    Why are you getting so angry about something that naturally takes a long time to heal?

Answer

The response acknowledging the frustration of losing physical abilities is the most therapeutic because it validates the client's feelings through reflection.
The correct answer employs reflection, a therapeutic communication technique that acknowledges and validates the client's feelings of frustration and loss. By recognizing the difficulty of losing relied-upon physical abilities, the nurse demonstrates empathy and keeps the lines of communication open, allowing the client to safely express their grief without feeling judged.

Step-by-Step Solution

1
Analyze the client's statement and behavior to identify the underlying emotional need.
The client is expressing deep grief, frustration, and a loss of identity related to new physical limitations.
Identifying the core emotion accurately is required to choose the most appropriate therapeutic response.
2
Evaluate the communication techniques used in each provided option.
One option reflects and validates feelings, while the others rely on communication blocks such as giving advice, offering false reassurance, and asking 'why'.
Therapeutic communication requires addressing the client's emotional state openly without minimizing their experience or shutting down the conversation.
3
Select the option that best facilitates open communication and trust.
The reflective statement acknowledges the client's profound frustration and encourages further dialogue.
Validation builds the nurse-client relationship and supports the client's psychosocial adaptation to illness and disability.

Key Concept

Therapeutic Communication Techniques: Reflection and Validation
Estimated Time:1m 0s
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Topics

Therapeutic Communication

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