A nurse is caring for a client who has social anxiety disorder. The client reports experiencing feelings of anxiousness that disrupt their sleep. Which of the following recommendations should the nurse make?

Choice A reason: This response is appropriate because it respects the client's autonomy and comfort level. It is essential to acknowledge the client's feelings and preferences, especially when dealing with mental health issues like panic disorder. Massage therapy, while beneficial for some, may not be suitable for everyone, particularly if the idea of being touched exacerbates the client's anxiety. By offering to communicate the client's concerns to the provider, the nurse acts as an advocate for the client's well-being and ensures that the treatment plan is tailored to the client's specific needs and comfort.

Choice B reason: While this option might seem like a compromise, it does not address the client's fundamental discomfort with being touched. Wearing gloves may not alleviate the distress associated with physical contact for someone with panic disorder. It is crucial to consider the client's psychological state and the potential for gloves to serve as a reminder of the unwanted touch, possibly leading to increased anxiety rather than relief.

Choice C reason: Asking the client to explain their discomfort could be seen as dismissive of the client's stated boundaries and may put them in an uncomfortable position to justify their feelings. It is important for healthcare professionals to create a safe and supportive environment where clients do not feel pressured to defend their preferences or feelings, especially when they are already experiencing distress.

Choice D reason: This choice minimizes the client's concerns and could be perceived as invalidating their feelings. Telling a client not to worry about their anxiety, particularly in the context of a panic disorder, overlooks the complexity of the condition. Anxiety disorders can significantly impact a person's life, and reassurances like this may not be helpful and could potentially worsen the client's anxiety.

Being well-groomed can be an indicator of improved mental health, as it suggests the client is taking care of their personal hygiene and appearance, which can be neglected during severe anxiety episodes.

An increase in the amount of sleep and a decrease in the frequency of nightmares can be seen as an improvement in the client’s condition, as sleep disturbances are common in anxiety disorders.

Engagement in thought-stopping behavioral therapy and cognitive restructuring indicates that the client is actively participating in therapeutic activities designed to manage anxiety, which is a positive sign of improvement.

Consistent medication adherence, as reported by the client taking escitalopram 20 mg daily, is crucial for managing anxiety symptoms and indicates the client’s commitment to following the treatment plan.

The client’s weight remaining stable could be neutral, as it does not indicate a significant change. Verbalizing decreased appetite and gastrointestinal discomfort, feeling anxious about leaving the house, and stating that past bullying has led to anxiety are all signs that the client is still experiencing symptoms of anxiety. Therefore, these choices do not reflect an improvement in the client’s condition.