A nurse is using de-escalation techniques with a client who has become verbally aggressive with a staff member. Which of the following actions should the nurse take?

A. Illusion: An illusion is a misinterpretation or misperception of a real external stimulus. It involves a distortion of sensory perception, but the client's statement does not suggest a misperception of reality.

B. Hallucination: A hallucination is a sensory perception in the absence of any external stimulus. It involves experiencing something that is not present in reality. The client's statement does not indicate experiencing a sensory perception that is not real.

C. Attention-seeking behavior: While the client's statement may draw attention to their distress, it is important not to dismiss it as merely attention-seeking behavior. The client's request for the pen to alleviate emotional pain suggests a deeper psychological issue and a genuine risk for self-harm.

D. Self-mutilation: Self-mutilation refers to intentional self-inflicted injury or harm to one's body tissue without the intent to die. The client's statement about using the pen to cut the pain out of their chest indicates a clear risk for self-mutilation.

A. Encourage the client to attend group therapy sessions: While group therapy can be beneficial for some individuals with panic disorder by providing support and opportunities for learning coping strategies, it may not be appropriate for all clients. Some clients may feel overwhelmed or anxious in group settings, especially during panic attacks. The nurse should assess the client's readiness and comfort level with group therapy and individualize the treatment plan accordingly.

B. Allow the client to choose scheduled daily activities: Providing the client with a sense of control and autonomy over their daily activities can be helpful in managing anxiety and panic symptoms. However, this intervention alone may not address the specific cognitive and behavioral aspects of panic disorder. It is important to incorporate other evidence-based interventions, such as cognitive-behavioral therapy (CBT) techniques, into the treatment plan to address the underlying causes of panic attacks.

C. Use simple words to describe procedures to the client: Individuals with panic disorder may experience difficulty processing information and focusing during panic attacks or periods of heightened anxiety. Using simple and clear language to describe procedures can help reduce confusion and alleviate anxiety in these situations. It is important to provide information in a calm and reassuring manner to facilitate understanding and cooperation.

D. Avoid discussing topics that can trigger a panic attack: While it is important to be mindful of potential triggers for panic attacks, avoiding all discussion of triggering topics may not be practical or helpful in the long term. Instead, the nurse should work collaboratively with the client to identify triggers and develop coping strategies to manage them effectively. Avoidance alone may reinforce avoidance behaviors and perpetuate anxiety.