During the first group, Sam says 'The medications cause too many side effects. I have been taking them for a long time.' Which nursing problem should be documented for the group progress note?

• A. Ineffective denial.
• B. Knowledge deficit.
• C. Ineffective coping.
• D. Risk for adherence.

Answer: (D)

The main concept here is recognizing a patient’s risk for not following the prescribed treatment because of attitudes about the medication. Sam is expressing that the meds cause too many side effects and that he has been on them a long time, which signals potential barriers to continuing treatment. This points to a risk for adherence, since concerns about adverse effects and the burden of long-term therapy are common reasons patients don’t take meds as prescribed. It isn’t a knowledge deficit, because he acknowledges the meds and their side effects, and it isn’t clear evidence of denial or of ineffective coping—those aren’t the primary barriers shown here. In the group note, document this risk for adherence and plan to explore specific side effects, strategies to manage them, and ways to support continued, appropriate medication use.