Question

A nurse is caring for a client who experienced short-term memory loss as a result of a head injury. Which of the following statements made by the nurse regarding goal setting requires follow-up by the nurse manager?

1. The client will certainly need frequent reorientation to the care plan goals.
2. I will restate the goals I've created for him regularly so as to win his compliance.
3. I'm not sure that his family will be able to support him with these goals but I will discuss it with them.
4. He seems very willing to work towards achieving his goals but his condition will certainly create barriers.

Answer 1

The statement made by the nurse that implies unilaterally creating goals for the client requires follow-up by the nurse manager to ensure client engagement and personalized care are prioritized.

Step-by-step explanation:

The statement made by the nurse that requires follow-up by the nurse manager is: I will restate the goals I've created for him regularly so as to win his compliance. This approach is problematic as it implies the nurse is unilaterally setting the goals without the client's active engagement, which can be counterproductive and may not address the client's personal goals and needs. Instead, the nurse should facilitate the client's involvement in goal setting and use the client’s input to help guide care plans and treatment strategies. Strategies to address memory could include tasks like the three-word recall test, spelling words backwards, or reciting the months in reverse order, and may need adjustments based on the client's condition and response.