Instructor Manual for Psychiatric Mental Health Nursing , Concepts of Care in Evidence-Based Practice 8th Edition by Mary C. Townsend

Instructor Manual for Psychiatric Mental Health Nursing , Concepts of Care in Evidence-Based Practice 8th Edition by Mary C. Townsend

Suggested Answers to Assignments, Chapter 9, Legal and Ethical Issues

Written Assignment

Learning Objective

1. Students’ answers should include the following:

• Right to refuse medication or treatment
• Right to confidentiality
• Right to the least restrictive environment
• Right to leave the hospital, unless they represent a dangerousness to themselves or others

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Group Assignments

Learning Objective(s)

1. Students’ answers should include the following:

• Short-term use of restraint or seclusion is permitted only when the client is imminently aggressive and dangerous to himself or herself or to others.
• Requires a physician’s order every 8 hours and assessment by the nurse every 2 to 4 hours, close supervision of the client, and face-to-face evaluation by a licensed independent practitioner within 1 hour of restraint or seclusion.

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2. Students’ answers should include the following:

• A discussion of your views regarding this ethical dilemma and your associated defense of the stated view.

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3. Students’ answers should include the following:

• Duty, breach of duty, injury or damage, and causation.

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Clinical Assignment

Learning Objective

1. Students’ answers should include the following:

• Practice within the scope of state laws and nurse practice act
• Use established practice standards to guide decisions and actions
• Always put the client’s rights and welfare first

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Web Assignment

Learning Objective

1. Students’ answers should include the following:

· A summarization of the ANA’s Scope and Standards of Psychiatric–Mental Health Nursing Practice.

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Suggested Answers to Assignments, Chapter 10, Grief and Loss

Written Assignments

Learning Objective(s)

1. Students’ answers should include the following:

• Experiencing numbness and denying the loss
• Emotionally yearning for the lost loved one and protesting the permanence of the loss
• Experiencing cognitive disorganization and emotional despair with difficulty functioning in the everyday world
• Reorganizing and reintegrating the sense of self to pull life back together

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2. Students’ answers should include the following:

• Denial, anger, bargaining, depression, and acceptance

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Group Assignments

Learning Objective(s)

1. Students’ answers should include the following:

• Universal reactions include shock, social disorientation, anger, and mourning.
• Religious or spiritual beliefs and practices regarding death frequently guide the client’s mourning. Cultural bereavement rituals have roots in several of the world’s major religions.

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2. Students’ answers should include the following:

• A discussion of how the woman in the movie, The Last Best Year, comes to terms with her own death and her past experiences.

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Clinical Assignments

Learning Objective(s)

1. Students’ answers should include the following:

• A determination of whether the assigned client’s losses were tangible or intangible and what kind of loss he or she endured and associated grieving behaviors.

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2. Students’ answers should include the following:

• Characteristics of people who are vulnerable to complicated grieving include low self-esteem, low trust in others, a previous psychiatric disorder, previous suicide attempts, absence of family members, and dependent or insecure attachment to the deceased person.
• Risk factors leading to vulnerability include death of a spouse or child, death of a parent, sudden, unexpected, and untimely death, multiple deaths, and death by suicide or murder.

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3. Students’ answers should include the following:

• A relationship has no legitimacy, the loss itself is not recognized, and the griever is not recognized
• Nurses may experience disenfranchised grief when their need to grieve is not recognized. The daily intensity of relationships between nurses and clients or families creates strong bonds among them.

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Web Assignment

Learning Objective

1. Students’ answers should include the following:

• A summarization of information and usefulness provided by an Internet Web site related to how the nursing process is used to facilitate grieving for clients and families.

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Suggested Answers to Assignments, Chapter 11, Anger, Hostility, and Aggression

Written Assignments

Learning Objective(s)

1. Students’ answers should include the following:

• Depression, antisocial personality disorder, dementia, delirium, head injuries, alcohol or drug intoxication, and borderline personality disorder.

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2. Students’ answers should include the following:

• Triggering, escalation, crisis, recovery, and postcrisis.

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Group Assignment

Learning Objective

1. Students’ answers should include the following:

• Interventions are most effective and least restrictive when implemented early in the cycle of aggression.

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Clinical Assignment

Learning Objective

1. Students’ answers should include the following:

• Interventions appropriate for each phase of the aggression cycle (triggering, escalation, crisis, recovery, and postcrisis)
• Triggering—use of nonthreatening calm manner
• Escalation—the nurse must take control of the situation; initiation of time-out
• Crisis—use of restraints if needed
• Recovery—the client is encouraged to talk about the situation or triggers that led to the aggressive behavior.
• Postcrisis—the client is removed from restraint or seclusion as soon as he or she meets the behavioral criteria.

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Web Assignment

Learning Objective

1. Students’ answers should include the following:

• A summarization of nursing issues and interventions when encountering an angry, hostile, or aggressive client.

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