The nurse is assisting a child with attention deficit hyperactivity disorder (ADHD) to complete the child's activities of daily living. Which is the best approach for nurse to use with this child?

Major Depressive Disorder is a mood disorder characterized by persistent feelings of sadness and a loss of interest, often linked to neurotransmitter imbalances involving serotonin, norepinephrine, and dopamine. Safety is the paramount concern in psychiatric nursing, as the risk of self-directed violence is significantly elevated during the acute phase of a depressive episode.

Rationale:

A. While providing a support system is a necessary part of the long-term treatment plan, it is not the immediate priority. The nurse must first determine the client's current safety status before coordinating external resources or secondary social interventions.

B. Determining who else knows about the diagnosis helps the nurse assess the client's support network. However, this is a psychosocial assessment piece that follows the critical screening for life-threatening behaviors and immediate risk to the client's physical well-being.

C. Encouraging a client to participate in milieu therapy is an important intervention for socialization. However, a newly diagnosed and potentially severely depressed client may not be ready for group interaction, and this question does not address the most urgent clinical risk: suicide.

D. Assessing for suicidal ideation is always the priority for a depressed client. The nurse must use direct, non-ambiguous language to determine if the client has a plan, the means to carry it out, and the immediate intent to self-harm. This assessment dictates the level of observation and precautions required for the client's safety.

Post-traumatic stress disorder involves maladaptive neurobiological responses following exposure to extreme stressors. It manifests through hyperarousal, intrusive re-experiencing, and avoidance behaviors. Patients often demonstrate exaggerated startle responses and sympathetic nervous system overactivity requiring targeted behavioral stabilization and emotional regulation strategies.

Rationale:

A. Dismissing the trauma as having no meaning invalidates the client's experience and hinders the therapeutic alliance. Such an approach prevents the necessary processing of cognitive distortions and emotional triggers, which are essential components for achieving long-term psychological recovery and stability.

B. Relaxation techniques, such as diaphragmatic breathing and progressive muscle relaxation, help modulate the autonomic nervous system. These tools empower clients to manage hypervigilance and physiological arousal during flashbacks, facilitating a return to a grounded, present state of safety.

C. Physical symptoms in PTSD, such as tachycardia or diaphoresis, are directly linked to the amygdala's activation. Nurses must explain this psychosomatic connection so clients understand their bodily responses are predictable biological reactions to perceived threats rather than independent medical issues.

D. Encouraging repression is counterproductive and may exacerbate dissociative symptoms over time. Evidence-based care focuses on gradual, controlled exposure and cognitive restructuring rather than pushing memories away, which typically leads to increased psychological distress and functional impairment.