The nurse is continuing to care for the client.

Exhibits

A nurse is evaluating the client's response to therapy. Which of the following recent findings indicate the client's condition has improved or not changed?
For each assessment finding, click to specify if the finding indicates that the client's condition has improved or has not changed.

Rationale:
A. Encourage the client to watch television: Distracting the client with television is not effective during an acute panic attack. The client may be too anxious to focus, and this approach does not provide emotional support or safety.

B. Teach the client how to meditate: Teaching meditation is a long-term coping strategy and is not helpful during an acute panic attack, when the client requires immediate support and reassurance.

C. Administer a dose of atomoxetine to decrease anxiety: Atomoxetine is used to treat attention-deficit/hyperactivity disorder (ADHD) and is not indicated for acute anxiety or panic attacks. Medications for acute panic typically include fast-acting benzodiazepines if prescribed.

D. Sit with the client to provide a sense of security: Providing a calm presence and sitting with the client helps reduce feelings of fear and isolation. This intervention offers immediate emotional support, reassurance, and a sense of safety during the panic episode.

Rationale:
A. Discharge the client to hospice care: While hospice care may be appropriate for clients with end-stage disease, discharge to hospice is not the immediate nursing action in response to a DNR request. The priority is to acknowledge the client’s wishes and ensure the DNR order is properly documented.

B. Place a sign with "Do Not Resuscitate" outside the client's room: A visible sign is used after a formal DNR order is entered into the medical record. Placing a sign prematurely without provider authorization or documentation does not legally protect the client’s wishes.

C. Explain to the client they can change their mind at any time: It is important to respect client autonomy while clarifying that a DNR order is revocable. Providing this information supports informed decision-making and ensures the client understands that their preferences can be updated at any time.

D. Obtain consent from the family for the change to the plan of care: The client’s decision regarding resuscitation takes priority if they have decision-making capacity. Family consent is not required for a competent adult to make a DNR decision.