A nurse in a long-term care facility is caring for an older adult client who is anxious and has trouble sleeping at night. Which of the following nursing measures should the nurse implement?

This response reflects the therapeutic communication technique of reflection and validation. By acknowledging the client's feelings and reflecting on them back, the nurse shows empathy and encourages further discussion. It allows the client to express their emotions and concerns, fostering a trusting and supportive relationship between the nurse and the client.

incorrect:

A. "You are in really good shape for your age." This response dismisses the client's expressed feelings of despair and does not address the underlying emotions. It fails to acknowledge the client's emotional state and may minimize their concerns.

B. "This is just a minor setback. You will be back on your feet in no time." While the intention may be to provide reassurance, this response invalidates the client's feelings of hopelessness and disregards the significance of their emotional experience. It does not address the client's statement of feeling that their time is up.

C. "The doctors are going to take good care of you. There is nothing to worry about." This response focuses solely on the medical aspect of care and may disregard the client's emotional and existential concerns. It fails to acknowledge the client's expressed feelings of their time being up and does not encourage further exploration of their emotions.

The appropriate response for the nurse in this situation would be: "I'll just sit here with you for a few minutes then."
This response acknowledges the client's expressed desire not to talk and respects their boundaries. It shows support and presence by offering companionship without pressuring the client to discuss their feelings. The nurse's willingness to sit with the client demonstrates empathy and provides a sense of comfort and reassurance.
The other options are not as appropriate:

1. "It might help you feel better if you talk about it." This response disregards the client's stated preference not to talk and may create a sense of pressure or intrusiveness. It is important to respect the client's autonomy and readiness to share their feelings.
2. "Why are you feeling so down?" This response directly asks the client to explain their feelings, which they have already indicated they do not want to discuss. It can be seen as intrusive and may make the client feel uncomfortable or defensive.
3. "I understand. I've felt like that before, too." While empathy is important, this response brings the focus back to the nurse's own experiences, potentially diverting the attention from the client. It is important for the nurse to remain focused on the client's needs and create a supportive environment for them to express their feelings if they choose to do so.