Which nursing intervention provides information that can be built on in order to help a client cope with a traumatic experience?

Set a working relationship with the patient through continuity of care.  An ongoing relationship establishes trust, reduces the feeling of isolation, and may facilitate coping. Assist patient set realistic goals and identify personal skills and knowledge. Involving patients in decision making helps them move toward independence. Provide chances to express concerns, fears, feeling, and expectations. Verbalization of actual or perceived threats can help reduce anxiety and open doors for ongoing communication. Use empathetic communication. Acknowledging and empathizing creates a supportive environment that enhances coping. Convey feelings of acceptance and understanding. Avoid false reassurances. An honest relationship facilitates problem-solving and successful coping. False reassurances are never helpful to the patient and only may serve to relieve the discomfort of the care provider. Encourage patient to make choices and participate in planning of care and scheduled activities. Participation gives a feeling of control and increases self-esteem. Encourage the patient to recognize his or her own strengths and abilities. During crises, patients may not be able to recognize their strengths. Fostering awareness can expedite use of these strengths. Consider mental and physical activities within the patient’s ability (e.g., reading, television, outings, movies, radio, crafts, exercise, sports, games, dinners out, and social gatherings). Interventions that improve body awareness such as exercise, proper nutrition, and muscular relaxation may be helpful for treating anxiety and depression. Assist patients with accurately evaluating the situation and their own accomplishments. It can be helpful for the patient to recognize that he or she has the skills and reserves of strength to effectively manage the situation. The patient may need help coming to a realistic perspective of the situation. If the patient is physically capable, encourage moderate aerobic exercise. Aerobic exercise improves one’s ability to cope with acute stress. Provide information the patient wants and needs. Do not give more than the patient can handle. Patients who are coping ineffectively have reduced ability to absorb information and may need more guidance initially. Provide touch therapy with permission. Give patient a back massage using slow, rhythmic stroking with hands. Use a rate of 60 strokes a minute for 3 minutes on 2-inch wide areas on both sides of the spinous process from the crown to the sacral area. A soothing touch can reveal acceptance and empathy. Slow stroke back massage decreased heart rate, decreased systolic and diastolic blood pressure, and increased skin temperature at significant levels. The conclusion is that relaxation is induced by slow stroke back massage. Assist the patient with problem-solving in a constructive manner. Constructive problem solving can promote independence and sense of autonomy. Provide information and explanation regarding care before care is given. In traumatic situations, families have a need for information and explanations. Providing information prepares the patient and family for understanding the situation and possible outcomes. Eliminate stimuli in an environment that could be misinterpreted as threatening. The presence of noise associated with medical equipment can increase anxiety and make coping more challenging. Discuss changes with patient before making them. Communication with the medical staff provides patients and families with understanding of the medical condition. Provide outlets that foster feelings of personal achievement and self-esteem. Opportunities to role-play or rehearse appropriate actions can increase confidence for behavior in actual situations. Point out signs of positive progress or change. Patients who are coping ineffectively may not be able to assess their progress toward effective coping. Encourage use of cognitive behavioral relaxation (e.g., music therapy, guided imagery). Relaxation techniques, desensitization, and guided imagery can help patients cope, increase their sense of control, and allay anxiety. Be supportive of coping behaviors; give patient time to relax. A supportive presence creates a supportive environment to enhance coping. Discuss with patient about his or her previous stressors and the coping mechanisms used. Describing previous experiences strengthens effective coping and helps eliminate ineffective coping mechanisms. Use distraction techniques during procedures that cause patient to be fearful. Distraction is used to direct attention toward a pleasurable experience and block the attention of the feared procedure. Apply systematic desensitization when introducing new people, places, or procedures that may cause fear and altered coping. Fear of new things diminishes with repeated exposure. Refer for counseling as necessary. Arranging for referral assists the patient in working with the system, and resource use helps to develop problem-solving and coping skills. Refer to medical social services for evaluation and counseling. This will promote adequate coping as part of the medical plan of care. If the patient is associated with the mental health system, actively engage in mental health team planning. Based on knowledge of the home and family, home care nurses can often advocate for patients. These nurses are often requested to monitor medications and therefore need to know the plan of care.

Which question will help the nurse assess the client's ability to experience a sense of connection with life and nature?

Which is most essential when planning care for a client who is experiencing a crisis?

Which characteristics and skills does the nurse convey and use to rapidly establish rapport with the client?

Which goal is the priority in planning the care for a client in crisis?