A nurse in an urgent care clinic is caring for an infant who presents with vomiting, diarrhea, and decreased oral intake. Which of the following manifestations should the nurse expect?

Rationale:

A. Tell the client to sit alone in a private place and reflect on the situation: Clients in a panic state are overwhelmed, disorganized, and unable to focus. Leaving them alone can increase feelings of isolation and fear, worsening the anxiety.

B. Use short sentences when communicating with the client: During panic-level anxiety, the client's ability to process information is impaired. Clear, concise communication helps reduce confusion and provides a sense of control and safety.

C. Have the client journal about what is happening to him: Journaling requires introspection and cognitive organization, which are not possible when a client is in a panic state. This intervention is more appropriate once anxiety levels have decreased.

D. Encourage the client to talk about his feelings: While verbalizing emotions is therapeutic, a client in panic may not be able to articulate thoughts. The priority is to first reduce the anxiety to a manageable level using calm, simple guidance.

Rationale:

A. Request a change in medication from the provider: Medication adjustments should be based on a full assessment of the child’s symptoms and patterns. Requesting a change prematurely may lead to ineffective or inappropriate treatment.

B. Refer the family to a chronic pain support group: Support groups are helpful for long-term coping and education, but they are not an immediate action. The nurse must first assess the current situation to guide any referrals.

C. Set up an appointment with the school nurse: While school involvement can support symptom management, especially for triggers or academic impact, it is not the initial step. The nurse must first gather complete data on the headaches.

D. Review the child's electronic pain diary: The pain diary provides detailed information about frequency, triggers, intensity, and patterns of the migraines. Reviewing it is the first step to making informed decisions about the child’s care plan.