A nurse is caring for a client whose partner has recently died. The client ‘’I am learning how to pay my own bills.’’ The nurse should identify that the client is experiencing which of the following tasks in Worden’s Four Tasks of Grieving?
Experiencing the pain of grief
Finding an enduring connection while embarking on a new life
Accepting the reality of the loss
Adjusting to an environment without the deceased
The Correct Answer is D
A) Experiencing the pain of grief:
Experiencing the pain of grief is one of the early stages of mourning, according to Worden's tasks of grieving. This task involves confronting and processing the emotional pain and sorrow that accompany the loss. However, the statement provided by the client — "I am learning how to pay my own bills" — suggests they are adapting to life changes and responsibilities, which is more aligned with the later stages of grieving. This does not reflect the immediate pain of grief, but rather a focus on adjusting to life after the loss.
B) Finding an enduring connection while embarking on a new life:
Finding an enduring connection while embarking on a new life refers to the task of establishing a continued relationship with the deceased, while simultaneously moving forward with one's life. While this task is essential in the long-term grieving process, it does not directly relate to the client's statement, which focuses on practical changes, such as learning to manage finances, rather than a spiritual or emotional connection with the deceased.
C) Accepting the reality of the loss:
Accepting the reality of the loss is another important task in Worden’s model. This involves coming to terms with the fact that the loved one is gone. However, the client's focus on learning practical tasks like paying bills indicates that they are already moving beyond the initial stages of grief, not just accepting the loss. The statement does not clearly indicate that the client is still in the phase of accepting the reality of the loss, but rather adjusting to the changes that the loss has brought.
D) Adjusting to an environment without the deceased:
The client's statement, "I am learning how to pay my own bills," suggests they are taking on new responsibilities and adjusting to the changes brought about by the death of their partner. This aligns with Worden’s task of adjusting to an environment without the deceased, which includes taking on new roles and responsibilities that the deceased partner previously managed, such as financial tasks, household duties, and other life changes.
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Correct Answer is B
Explanation
A) Denial:
Denial is the first stage in Kubler-Ross's model of grief. It typically involves a person having difficulty accepting the reality of their diagnosis or the reality of death. Clients in the denial stage may refuse to acknowledge the seriousness of their condition or may act as if everything is fine despite the obvious signs of illness. The statement “I am ready to update my will” suggests that the client has already accepted the reality of their terminal diagnosis and is preparing for what is to come, which is not characteristic of denial.
B) Acceptance:
Acceptance is the final stage in the Kubler-Ross model of grief. It is marked by coming to terms with the reality of death or a terminal diagnosis. Clients who are in the acceptance stage have typically processed their grief and are ready to make practical decisions, such as updating a will or making arrangements for the end of life. The client’s statement about updating their will reflects an acceptance of their condition and a focus on finalizing matters, which aligns with the stage of acceptance.
C) Anger:
Anger is a stage in the Kubler-Ross model of grief where individuals may feel frustrated, resentful, or upset about their situation. Clients in the anger stage may express feelings of injustice or frustration, often lashing out at others. Since the client is talking about practical matters such as updating their will, this does not indicate the emotional response of anger, which would be more likely to involve blaming others or feeling bitter.
D) Bargaining:
Bargaining is the stage where a person may make deals or promises in an attempt to delay or avoid the reality of their situation. Clients in the bargaining stage may attempt to negotiate with a higher power, themselves, or others, asking for more time or for changes in their circumstances. Since the client’s statement is about accepting the terminal diagnosis and preparing for the future, it is not indicative of bargaining, which often involves a desire for a change or a different outcome.
Correct Answer is D
Explanation
Choice D:
The client seems to be more comfortable performing self-administration of insulin: The use of the term “seems” introduces subjectivity, which weakens the clarity and objectivity of the documentation. It’s better to describe specific observations or objective findings. For instance, instead of using “seems,” the nurse could note how the client demonstrated confidence or performed the task with ease, providing concrete evidence of improvement.
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