A nurse is caring for a client who has a chronic illness. In which phase of the therapeutic relationship should

the nurse help the client develop problem-solving skills?

A. You have the right to refuse the recommended treatment plan.

As a nurse, it’s essential to respect the autonomy and decision-making capacity of your patients. Patients have the right to make informed choices about their own healthcare, including whether to accept or decline treatment recommendations. By acknowledging the patient’s right to refuse treatment, you empower them to be active participants in their care.

B.Option b is not the correct answer because it focuses on informing the provider without addressing the client's concerns or providing guidance.

C.Option c is not the correct answer because it emphasizes the medical consequences of not treating the cancer without acknowledging the client's personal beliefs or values.

D. In cases like yours, it is best to talk with your clergyperson before deciding this.

While option D acknowledges the importance of seeking emotional and spiritual support during difficult decisions, it does not directly address the patient’s right to refuse treatment. As a nurse, your primary responsibility is to respect the patient’s autonomy and provide accurate information about their treatment options. Encouraging open communication with a clergyperson or any other trusted individual can be beneficial, but it should not override the patient’s right to make their own decisions regarding their healthcare.

c. Instruct the client to use abdominal breathing.

When a client is experiencing a panic atack, the nurse's first priority is to help the client manage their symptoms and provide immediate relief. Instructing the client to use abdominal breathing is the most appropriate initial intervention.

Explanation for the other options:

a. Discuss the client's feelings prior to the panic atack. While discussing the client's feelings can be beneficial in addressing the underlying causes of anxiety, it may not be the most effective immediate intervention during a panic atack. The client's focus during a panic atack is typically on managing the physical symptoms and regaining control.

b. Encourage the use of positive self-talk strategies. Positive self-talk can be helpful in managing anxiety in general, but during a panic atack, the individual may have difficulty engaging in positive self-talk due to the intensity of symptoms. Addressing the immediate physical symptoms is a priority before exploring coping strategies.

d. Administer an anti-anxiety medication. Medication administration may be necessary in some cases, but it is not the first-line intervention for managing a panic atack. Non-pharmacological interventions, such as breathing techniques, should be implemented first. If the panic atack persists or worsens despite these interventions, medication may be considered.

In summary, during a panic atack, the immediate focus should be on helping the client manage their symptoms. Instructing the client to use abdominal breathing can help promote relaxation and reduce the intensity of the panic atack.