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Difficulty: HardTherapeutic Communication

A nurse is caring for a client who is preparing for discharge to a skilled nursing facility following a complex cerebrovascular accident. The client pushes their food tray away, begins crying softly, and says to the nurse, "I am just a useless burden to everyone. My children are sending me away because they are tired of dealing with me." Which of the following statements by the nurse demonstrate appropriate therapeutic communication? (Select all that apply.)

  1. It appears that the upcoming transfer is causing you to feel discarded and burdensome to your family.Answer
  2. B
    What makes you think your children are sending you away when they specifically chose a place close to their home?
  3. I can sit here with you for a while if you would like to talk about what you are experiencing.Answer
  4. D
    Everything will be alright once you settle in and meet the other residents at the facility.
  5. Please share more about the specific concerns you have regarding the transition to the skilled nursing facility.Answer
  6. F
    You really should look at the bright side; you will have continuous help and won't have to worry about cooking or cleaning.

Answer

The therapeutic responses involve reflecting the client's feelings ('It appears that the upcoming transfer...'), offering self ('I can sit here with you...'), and exploring ('Please share more about...').
Therapeutic communication prioritizes the client's emotional well-being by validating their experiences and creating a safe space for expression. Statements that reflect the client's feelings (acknowledging the sense of being discarded), offer the nurse's presence (sitting quietly to demonstrate support), and utilize open-ended exploration (asking them to share more concerns) are all evidence-based therapeutic techniques. These approaches demonstrate empathy, actively listen to the client's distress, and encourage them to process their complex emotions regarding the loss of independence.

Step-by-Step Solution

1
Analyze the client's emotional state and underlying needs based on their statement and behavior.
The client is experiencing grief, powerlessness, and feelings of abandonment related to the loss of independence and the impending transfer.
Understanding the client's psychosocial distress is essential for selecting a response that validates their emotional pain rather than dismissing it.
2
Evaluate each nursing statement to determine if it utilizes a therapeutic or non-therapeutic communication technique.
Reflecting feelings, offering self, and exploring are therapeutic. Defending, offering false reassurance, and giving personal advice are non-therapeutic.
Therapeutic communication should foster trust, validate feelings, and encourage the client to express themselves without fear of judgment.
3
Select all options that represent evidence-based therapeutic communication strategies.
The correct selections are the statements that reflect feelings, offer the nurse's presence, and invite further sharing.
These strategies align with the principles of psychosocial integrity by actively addressing the client's emotional needs.

Key Concept

Therapeutic Communication Techniques
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Topics

Therapeutic Communication

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