The nurse is taking care of a client from a culture different from the nurse's culture. How might the nurse best provide culturally competent care?

During a panic attack, the client may experience intense fear and anxiety, accompanied by physical symptoms such as rapid heart rate, shortness of breath, and trembling. The most critical action the nurse should take is to stay with the client and provide support. By remaining present, the nurse can help the client feel safe and reassured, while also monitoring their condition for any signs of worsening distress or the need for further intervention. Maintaining a safe environment is also crucial to prevent any harm to the client or others. Once the immediate crisis is managed and the client starts to calm down, the nurse can then proceed with other interventions, such as education on coping strategies or engaging in activities to redirect their focus. However, in this situation, the priority is to provide immediate support and ensure the client's safety.

The following are incorrect because:

Educate the client in ways to prevent a future panic attack: While education on preventing future panic attacks is important, it is not the priority action during an ongoing panic attack. The client is currently in distress and needs immediate support and assistance in managing the panic attack. Education can be provided at a later time when the client is calmer and more receptive to learning.

Take the client for a walk around the unit: Taking the client for a walk may be a beneficial intervention to help reduce anxiety and promote relaxation in some situations. However, during an active panic attack, the client may be experiencing significant distress and physical symptoms that can make movement difficult or exacerbate their symptoms. It is essential to prioritize the client's immediate needs and provide a supportive environment before considering other activities or interventions.

Redirect the client to an activity or task: Redirecting the client to an activity or task may be helpful in some situations to distract them from their anxiety. However, during a panic attack, the client may find it challenging to engage in activities or focus on tasks due to their heightened state of anxiety. Redirecting their attention without addressing their immediate distress may not be as effective or appropriate as providing support and maintaining a safe environment.

A. “I can see you are anxious. Let's stop for a minute."This option interrupts the exposure process. In systematic desensitization, the goal is to continue exposure while employing relaxation techniques, so stopping would not promote the gradual reduction of anxiety.

B. “Use the deep breathing techniques we practiced yesterday."This statement encourages the client to utilize a relaxation technique (deep breathing) while facing their fear, which is the core of systematic desensitization. By practicing relaxation in the presence of the feared stimulus, the client learns to associate the stimulus with calmness rather than anxiety.

C. "What is the worst that will happen if you confront this fear?"This option uses a form of cognitive restructuring, which is more aligned with cognitive-behavioral therapy (CBT) rather than systematic desensitization. This focuses on changing thought patterns rather than gradually exposing the person to their fear while inducing relaxation.

D. “Tell me how you are feeling right now."While it is important for the client to reflect on their feelings, this option does not promote relaxation or directly help the client manage their anxiety response during exposure. It focuses more on emotional processing rather than applying the desensitization technique.