A nurse is caring for a client who has depression.

After two days of treatment, the nurse notices that the client is suddenly more active and there are no longer signs of a depressive state.

Which of the following interventions should the nurse recommend for the plan of care?

The correct answer is choice A and D.

Choice A rationale:

Establishing rapport with the client is a fundamental nursing action to create a trusting relationship, which is especially important when a client is experiencing acute anxiety. A strong rapport can help the client feel more secure and supported, making it easier to manage their anxiety.

Choice B rationale:

Making eye contact is generally considered a non-threatening and effective way to communicate care and attention. Avoiding eye contact could make the client feel isolated or ignored. Therefore, this is not a recommended action when attending to a client with acute anxiety.

Choice C rationale:

Using a high-pitched voice can be perceived as alarming or stressful, which may exacerbate the client’s anxiety. It is important to use a calm, soothing tone when speaking to someone who is anxious.

Choice D rationale:

Validating the client’s feelings and identifying the cause of the anxiety are therapeutic techniques that acknowledge the client’s experience and can help in addressing the underlying issues contributing to the anxiety. This can be a crucial step in helping the client to cope with and overcome their anxiety.

Choice A:

While this response is well-intentioned, it may not be the most therapeutic in this situation. It could be perceived as dismissive of the client's feelings and concerns. Clients with schizophrenia often have difficulty trusting others, and this response could reinforce the client's belief that they are being held against their will.

It's important to acknowledge the client's feelings and concerns, rather than simply stating that the healthcare team is there to help.

Choice B:

This response is the most therapeutic because it uses the technique of reflection. Reflection involves echoing back the client's feelings or thoughts, which can help them feel heard and understood. It can also encourage the client to elaborate on their concerns.

By reflecting the client's statement, the nurse validates their feelings and opens the door for further communication.

Choice C:

This response could be perceived as confrontational or challenging, which could further escalate the client's anxiety. It's generally more helpful to start with a more open-ended question or reflection.

Asking "why" questions can sometimes make people feel defensive or put on the spot.

Choice D:

While relaxation techniques can be helpful for some clients, this response is not appropriate in this situation. It minimizes the client's concerns and does not address their underlying feelings of fear and anxiety.

It's important to validate the client's feelings before suggesting coping strategies.