A nurse in an outpatient setting is caring for a client.
The client presents with feelings of anxiety and depression.
They recently started smoking marijuana as that is what their "new friends do all the time". They admit to using laxatives frequently and running for 1 hr after eating a very large meal, which happens at least 9 times a week.
They were recently arrested for stealing make-up from a local department store and acknowledge that this "is the first time I was caught". Complete the diagram by specifying what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

Rationale:

Choice A: While offering hope and highlighting potential positives can be important in supporting someone with depression, this statement feels dismissive of the client's current experience and minimizes the intensity of their feelings. It could inadvertently make them feel unheard and misunderstood.

Choice B: While acknowledging the commonality of these feelings in depression is important for normalization, it can feel impersonal and fail to address the individual's specific struggles. It focuses on the diagnosis rather than the person's unique experience.

Choice D: Asking "why" can feel interrogative and put pressure on the client to explain their complex emotions. The focus should be on actively listening and validating their feelings rather than seeking justifications.

Choice C: This response demonstrates active listening and reflects back the client's core feeling (lack of meaning) without judgment. It shows empathy and opens the door for further exploration of their thoughts and emotions. It encourages the client to elaborate on their experience and potentially identify areas where meaning can be rediscovered.

Elaboration:

Suicide ideation and attempts are often linked to feelings of hopelessness and a perceived lack of value or purpose in life. When caring for someone with major depressive disorder who has expressed these thoughts, the primary goal is to establish safety and create a space for open communication.

Using therapeutic communication techniques like reflection, validation, and open-ended s allows the nurse to build trust and rapport with the client. Reflecting their feelings, as in Choice C, demonstrates understanding and helps the client feel heard and accepted. This can be a crucial step in reducing their distress and fostering a sense of hope and possibility.

By creating a safe and supportive environment, the nurse can encourage the client to explore their thoughts and feelings about their life and identify potential sources of meaning and hope. This can be a vital step in their journey towards recovery and well-being.

Choice A rationale:

While a client's unwillingness to accept treatment can be a challenge, it does not, in and of itself, meet the criteria for involuntary hospitalization beyond the initial 72-hour hold.

Forced treatment without a clear and imminent risk of harm can violate a patient's autonomy and rights.

It's crucial for healthcare professionals to balance a patient's right to self-determination with the need to protect individuals from harm.

Choice B rationale:

A client's plan to move out of state, even if it's considered a disruptive decision, does not constitute grounds for involuntary hospitalization.

Individuals have the right to freedom of movement and to make choices about their life, even if those choices are perceived as unwise or problematic.

Choice C rationale:

This is the correct answer because it aligns with the fundamental principle of involuntary hospitalization: to protect individuals who pose a serious risk of harm to themselves or others due to a mental health condition.

This rationale is rooted in the ethical and legal obligation to prevent harm and ensure public safety.

Choice D rationale:

A client's dislike of a neighbor is not a valid reason for involuntary hospitalization. Personal opinions or feelings, even if negative, do not automatically translate into a risk of harm that would justify involuntary confinement.