A nurse in a rheumatology clinic is caring for a client newly diagnosed with systemic lupus erythematosus. The client speaks harshly to the nurse, stating, "You are all incompetent and clearly have no idea how to manage my care!" The client's spouse privately shares that the client is actually terrified of the disease progression and the potential loss of independence.
Which of the following nursing interventions are most therapeutic when responding to this client's coping behavior? (Select all that apply.)
- Maintain a calm, non-defensive posture and tone during interactions with the client.Answer
- BQuestion the client about why they feel the healthcare team is providing inadequate care.
- Acknowledge that receiving a complex, chronic diagnosis can be a frightening experience.Answer
- DConfront the client by explaining that their hostility is actually directed at the illness.
- Dedicate time to remain present and encourage the client to verbalize their genuine concerns.Answer
Answer
The correct therapeutic interventions include maintaining a non-defensive demeanor, acknowledging the frightening nature of the diagnosis, and dedicating time to encourage the client to express their genuine concerns.
When a client utilizes displacement, they redirect unacceptable feelings (such as fear of a chronic disease) onto a safer target (the nursing staff). The most therapeutic approach involves remaining calm and non-defensive, validating the underlying emotion (fear of the diagnosis), and providing a safe space for the client to express their genuine feelings without judgment. These actions lower the client's anxiety and help them begin to process their true concerns constructively.
Step-by-Step Solution
Key Concept
Therapeutic Communication and Maladaptive Coping