A nurse is caring for a client who is experiencing panic-level anxiety and is becoming increasingly agitated with the staff. Which of the following interventions should the nurse attempt first?

Administer a sedative medication to the client.

Encourage strenuous physical activity to decrease tension.

Encourage the client to explore feelings that contribute to anxiety.

Speak to the client using short and simple statements in calm voice.

Answer and Explanation

The Correct Answer is D

A) Administer a sedative medication to the client: While sedative medications can help manage acute anxiety, they should not be the first intervention. Medication administration comes after attempting non-pharmacological strategies to de-escalate the situation.

B) Encourage strenuous physical activity to decrease tension: Strenuous physical activity can sometimes exacerbate anxiety rather than alleviate it, particularly during a panic-level episode. It might not be safe or effective for immediate calming.

C) Encourage the client to explore feelings that contribute to anxiety: Exploring feelings is more appropriate once the client has been calmed. During a panic-level anxiety episode, the client may not be able to engage in reflective thinking or communication effectively.

D) Speak to the client using short and simple statements in calm voice: Using short, simple statements in a calm voice helps to provide clear and concise communication, which can be grounding and reassuring for someone experiencing panic-level anxiety. This approach helps to de-escalate the situation by reducing confusion and agitation.

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Correct Answer is C

Explanation

A) "After chewing an antacid, wait 1 hour before drinking water.": This is incorrect advice as drinking water after taking an antacid can help wash the medication down and ensure it reaches the stomach effectively. Waiting an hour to drink water is unnecessary and does not benefit GERD management.

B) "Plan to have a bedtime snack each evening.": Having a bedtime snack can exacerbate GERD symptoms by increasing stomach acid production just before lying down. Clients with GERD should avoid eating close to bedtime to minimize symptoms.

C) "Elevate the head of your bed 12 inches.": Elevating the head of the bed helps prevent stomach acid from flowing back into the esophagus during sleep, which can reduce nighttime GERD symptoms. This is a recommended non-pharmacological intervention for managing GERD.

D) "Eat a sugar-free peppermint when symptoms occur.": Peppermint can relax the lower esophageal sphincter, potentially worsening GERD symptoms by allowing stomach acid to reflux into the esophagus. Therefore, peppermint is not recommended for managing GERD symptoms.

A. Evaluate the client's understanding of diabetes management. B. Administer potassium supplements. C. Initiate a continuous infusion of 0.9% sodium chloride. D. Chek for improvements in the client's level of consciousness.

Correct Answer is C

Explanation

A) Evaluate the client's understanding of diabetes management: While it is important to assess the client’s understanding of diabetes management to prevent future hyperglycemic episodes, this is not the immediate priority. The client's current hyperglycemic-hyperosmolar state needs urgent intervention to stabilize their condition before educational measures can be effective.

B) Administer potassium supplements: Potassium supplementation may be necessary, especially if the client is hypokalemic, but it is not the first action. Electrolyte levels should be monitored and corrected as part of the treatment, but the initial priority is to address the severe dehydration and hyperglycemia.

C) Initiate a continuous infusion of 0.9% sodium chloride: This is the most critical first step. Clients in a hyperglycemic-hyperosmolar state are typically severely dehydrated due to osmotic diuresis. Initiating a continuous infusion of isotonic saline helps to restore intravascular volume, improve perfusion, and stabilize hemodynamics, which is essential before addressing other issues.

D) Check for improvements in the client's level of consciousness: Monitoring the client's level of consciousness is important as it provides information about their neurological status and response to treatment. However, this is a subsequent action after initiating fluid resuscitation, which directly addresses the immediate life-threatening aspects of the hyperglycemic-hyperosmolar state.

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A nurse is caring for a client who is experiencing panic-level anxiety and is becoming increasingly agitated with the staff. Which of the following interventions should the nurse attempt first?

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