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Zorluk: OrtaEnd of Life Care

An oncology nurse enters the room of a client with advanced pancreatic cancer who recently signed a Do Not Resuscitate (DNR) directive. The client is crying quietly and states, 'By signing that document, I feel like I am abandoning my children and giving up on my faith.' Which response by the nurse is the most therapeutic?

  1. This is clearly a very distressing time for you. Please share more about what giving up means to you in this moment.Cevap
  2. B
    Your children love you deeply and they understand that you have fought this illness as hard as you could.
  3. C
    Why would you think that making a medical decision for your physical comfort goes against your religious beliefs?
  4. D
    I will instruct the unlicensed assistive personnel to stay with you and provide comfort while I page the spiritual care team.

Cevap

The correct answer is the option that validates the client's feelings and uses open-ended communication to explore their concerns further.
The correct response utilizes two key therapeutic communication techniques: validation and broad opening. By acknowledging that this is a distressing time, the nurse validates the client's emotional state. Asking the client to share more about their feelings encourages the open expression of spiritual and emotional distress without judgment, assumptions, or defensive posturing.

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1
Analyze the client's statement and current emotional state.
The client is experiencing acute spiritual distress and feelings of guilt related to the recent DNR order.
Understanding the core of the client's distress is necessary to formulate an appropriate therapeutic response.
2
Identify the nurse's priority in this psychosocial scenario.
The priority is to establish trust, validate the client's emotions, and encourage the open expression of their feelings.
End-of-life care requires prioritizing emotional and spiritual support through active listening.
3
Evaluate the provided options against therapeutic communication principles.
Select the response that avoids false reassurance, does not ask 'why', and retains the assessment responsibility with the registered nurse.
Only one option provides a broad opening without minimizing the client's experience.

Anahtar Kavram

Therapeutic Communication in End of Life Care
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Konular

End of Life Care

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