Question

A patient has been admitted with a diagnosis of Post Traumatic Stress Disorder related to being a victim of a violent crime. The nurse observes he always sits with his back to the wall, is constantly scanning the environment, refuses to talk about the crime, screams and cries out in his sleep, and is not participating in activities on the milieu. While planning interventions for the patient, the nurse incorporates outcome criteria including: (select all that apply)

1 The patient is able to lead groups
2 The patient can acknowledge the trauma and the impact it's had on his life
3 The patient verbalizes forgiveness of his perpetrator
4 The patient demonstates less hypervigilance

Answer 1

Initial nursing interventions for a patient with PTSD should focus on achievable goals such as helping the patient acknowledge the trauma and demonstrate less hypervigilance, rather than expecting the patient to lead groups or verbalize forgiveness of the perpetrator.

Step-by-step explanation:

When planning interventions for a patient with Post-Traumatic Stress Disorder (PTSD), nurses should set realistic and personalized outcome criteria that address the patient's symptoms and promote recovery. While some specific interventions might aim for the patient to become more engaged in therapeutic activities, lead groups, or eventually be able to verbalize forgiveness, the initial focus should usually be on more immediate and achievable goals. Thus, the nurse’s plan should incorporate outcome criteria such as:

• The patient can acknowledge the trauma and the impact it's had on his life.
• The patient demonstrates less hypervigilance, indicating a decrease in anxiety and an increased sense of safety.

While leading groups may be a long-term goal, it may not be appropriate as an initial outcome criterion due to the complexity and the stage of the patient's recovery. The notion that the patient 'verbalizes forgiveness of his perpetrator' is controversial and not considered a necessary part of the recovery process for every individual suffering from PTSD. It is essential that treatment be tailored to the individual's needs, readiness, and cultural context, respecting their pace and personal boundaries in addressing the trauma.