Mental Health Nursing
Yemeni soldier caught in the war and he got many injuries.
The patient anxious and he is speaking about death for the nurse. What is the most appropriate action for the nurse?
الشرح
Core Concept: In mental health and trauma nursing, therapeutic communication techniques are essential to build trust and explore a patient's feelings. "Restating" (or reflecting) involves repeating the main idea or words of the patient to encourage them to elaborate and to validate their feelings without judgment.
Clinical Presentation:
- Severe anxiety, expressions of impending doom, trauma-related distress, and fear of death following a catastrophic event or severe injury.
Diagnosis:
- First-line diagnostic plan/tool: Active listening and psychological assessment of the patient's anxiety level and coping mechanisms.
- Gold standard diagnostic test: Comprehensive psychiatric evaluation if PTSD, severe acute stress disorder, or suicidal ideation is suspected.
Management:
- Acute management: Use therapeutic communication (restating, exploring, offering self), ensure physical safety, and provide a calm environment. Avoid asking "why" or giving false reassurance (e.g., "You won't die").
- Long-term/definitive management: Trauma-focused cognitive behavioral therapy (TF-CBT), psychological debriefing, and pharmacological management of severe anxiety or PTSD if indicated.