A client diagnosed with borderline personality disorder approaches the nurse's station with several fresh, superficial horizontal lacerations on their left forearm. The client appears calm and states, "I just felt so empty inside; I needed to do this to feel something real." What is the nurse's priority and most therapeutic intervention?
- Provide basic first aid to the wounds in a neutral, matter-of-fact manner, and then ask the client to identify the event that triggered the behavior.Cevap
- BOffer intense emotional support for the client's distress and gently ask, "Why did you feel that cutting yourself was the only way to cope today?"
- CImmediately initiate continuous one-to-one visual observation, as this behavior demonstrates an imminent risk for a lethal suicide attempt.
- DEscort the client to a locked seclusion room to ensure environmental safety while staff conducts a thorough search for sharp objects.
Cevap
The most therapeutic intervention is to provide basic first aid to the wounds in a neutral, matter-of-fact manner, and then ask the client to identify the event that triggered the behavior.
In clients with borderline personality disorder, superficial self-harm is often a maladaptive coping mechanism used to relieve emotional numbness or distress (NSSI), rather than a genuine suicide attempt. Providing excessive emotional attention during wound care acts as a secondary gain, which reinforces the behavior. The most therapeutic approach is to provide necessary first aid in a neutral, matter-of-fact manner. Once physical safety is secured, the nurse should guide the client to identify triggers and practice healthier coping strategies.
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Anahtar Kavram
Management of Non-Suicidal Self-Injury (NSSI) in Borderline Personality Disorder