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Zorluk: OrtaCoping Mechanisms

A practical nurse (PN) is caring for a young adult client who is scheduled for a complex surgical procedure the following morning. The client is crying, holding tightly to a childhood stuffed animal, and asks the PN to "please leave all the room lights on." The PN recognizes this behavior as regression in response to severe acute stress. Which response by the PN is the most therapeutic?

  1. "It is completely normal to feel frightened before a major surgery. I will leave the light on and check on you frequently."Cevap
  2. B
    "Why do you feel the need to hold a stuffed toy when you should be focusing on resting?"
  3. C
    "Do not worry about the surgery; you are in a great hospital and everything will go perfectly."
  4. D
    "I will update your nursing care plan right now to include a continuous bedside sitter for the night."

Cevap

The most therapeutic response is to validate the client's feelings of fear and accommodate their request for the light, which supports them appropriately through their current coping mechanism.
Validating the client's fear normalizes their emotional state and builds trust. Accommodating the harmless request (leaving the light on) provides immediate comfort and environmental control, effectively supporting the client as they utilize a regression coping mechanism during a high-stress crisis.

Adım Adım Çözüm

1
Analyze the client's behavior and current emotional state.
The client is exhibiting regression (reverting to earlier developmental coping behaviors, such as holding a toy and fearing the dark) due to preoperative anxiety.
Identifying the defense mechanism helps determine the level of emotional distress and the appropriate therapeutic intervention.
2
Determine the primary nursing goal for a client utilizing an adaptive or temporary defense mechanism.
The goal is to provide a safe, non-judgmental environment that acknowledges the client's emotional distress without shaming them.
Defense mechanisms like regression can temporarily protect the ego from overwhelming acute stress.
3
Evaluate the response options against principles of therapeutic communication and the PN scope of practice.
Select the response that uses validation and support. Reject non-therapeutic blocks (false reassurance, asking "why") or out-of-scope actions (altering the care plan unilaterally).
Therapeutic communication fosters trust, whereas communication blocks and scope violations compromise patient care and safety.

Anahtar Kavram

Therapeutic Communication and Defense Mechanisms
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Konular

Coping Mechanisms

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