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Difficulty: HardDevelopmental Stages and Transitions

A nurse is developing a plan of care for a 14-year-old adolescent who is hospitalized with a new diagnosis of type 1 diabetes mellitus. The client refuses to participate in diabetes education sessions, stating, "I am not doing this. I do not want to be different from my friends." Based on developmental stages and transitions, which nursing intervention is the most appropriate priority to support this client?

  1. A
    Provide a structured reward system that offers praise and privileges for each successfully completed education session.
  2. B
    Educate the client about the severe, long-term physiological complications of uncontrolled diabetes to emphasize the importance of compliance.
  3. Arrange for the client to interact with a peer support group of other adolescents managing type 1 diabetes.Answer
  4. D
    Instruct the parents to assume primary responsibility for the client's blood glucose monitoring and insulin administration.

Answer

Arrange for the client to interact with a peer support group of other adolescents managing type 1 diabetes.
The correct answer addresses the core conflict of Erikson's Identity versus Role Confusion stage. Adolescents place paramount importance on peer relationships, fitting in, and body image. By connecting the client with a peer support group of other adolescents with type 1 diabetes, the nurse helps normalize the condition, reduces feelings of isolation, and leverages peer influence to encourage participation in disease management.

Step-by-Step Solution

1
Analyze the client's age and clinical presentation.
The client is 14 years old and expressing a strong fear of being different from peers due to a new chronic illness diagnosis.
Identifying the client's developmental stage is required to select appropriate psychosocial interventions.
2
Correlate the client's age with the appropriate developmental theory.
According to Erikson's theory of psychosocial development, a 14-year-old is in the Identity versus Role Confusion stage.
Understanding the core conflict of the stage guides the nurse in addressing the client's primary psychosocial needs.
3
Evaluate the proposed interventions against the developmental needs of the adolescent.
Interventions that foster peer connections and normalize the experience align best with the adolescent's drive for peer acceptance and identity formation.
Developmentally appropriate interventions yield the highest level of client engagement and adherence.

Key Concept

Applying Erikson's stages of psychosocial development (Identity vs. Role Confusion) to adolescent patient care.
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Topics

Developmental Stages and Transitions

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