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Zorluk: OrtaFamily Dynamics

A home hospice nurse arrives for a scheduled visit to a client with end-stage amyotrophic lateral sclerosis (ALS). The client's spouse, who is the primary caregiver, is crying and states, "I just cannot do this anymore." The client's sibling, who recently arrived from out of town, is standing in the room arguing loudly, "You are completely neglecting my brother!" The client is awake in bed and visibly distressed by the interaction. Which of the following is the priority nursing action?

  1. A
    Proceed directly to the client's bedside to perform a physical assessment and evaluate for any physical signs of neglect.
  2. B
    Inform the sibling that the spouse has been providing 24-hour care and needs support rather than criticism.
  3. Request that the spouse and sibling step into another room, then acknowledge the emotional stress both are experiencing.Cevap
  4. D
    Instruct the sibling to leave the residence immediately until the spouse has had adequate time to calm down.

Cevap

The priority action is to ask the family members to step into another room and then acknowledge their emotional stress.
The correct action prioritizes the client's immediate emotional and physical safety by removing the loud conflict from the client's presence. Validating the feelings of both family members without taking sides establishes a therapeutic environment, addresses caregiver strain, and initiates neutral conflict resolution.

Adım Adım Çözüm

1
Assess the immediate environment and identify the primary threat to the client.
The loud argument is identified as an acute psychological stressor causing visible distress to the client.
Protecting the client from environmental and psychological harm is the nurse's first priority.
2
Intervene to separate the conflict from the client.
The spouse and sibling are directed to move their conversation to a different room.
This immediately resolves the environmental hazard for the client.
3
Utilize therapeutic communication to de-escalate the family members.
The nurse neutrally acknowledges the severe emotional strain both individuals are experiencing without taking sides.
Validation of feelings reduces defensiveness and opens the door for a collaborative discussion about caregiver strain and the client's care needs.

Anahtar Kavram

Family Dynamics and Conflict De-escalation
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Konular

Family Dynamics

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