A nurse is planning care using systematic desensitization for a client who has severe claustrophobia. Which of the following interventions should the nurse include in the plan of care?

Identify the client's preferred relaxation technique to use prior to each step of the therapy.

Administer an anxiolytic medication 1 hr prior to the scheduled therapy session.

Expose the client to an excess amount of anxiety-inducing stimulus to extinguish the phobia.

Ask the client to snap a rubber band worn on the wrist to minimize anxiety when thinking about the phobia.

Answer and Explanation

The Correct Answer is A

A) Identify the client's preferred relaxation technique to use prior to each step of the therapy:
Systematic desensitization involves gradually exposing the client to the anxiety-inducing stimulus while using relaxation techniques to manage anxiety. Identifying the client's preferred relaxation technique is crucial to help them remain calm and reduce their phobia-related anxiety during each step of the therapy.

B) Administer an anxiolytic medication 1 hr prior to the scheduled therapy session:
While anxiolytic medications can help reduce anxiety, systematic desensitization typically relies on non-pharmacological methods to help the client gradually overcome their phobia. The goal is for the client to develop coping mechanisms without medication.

C) Expose the client to an excess amount of anxiety-inducing stimulus to extinguish the phobia:
Exposing the client to an excess amount of anxiety-inducing stimuli is not appropriate for systematic desensitization. This method, known as flooding, can overwhelm the client and increase their anxiety, potentially worsening the phobia rather than alleviating it.

D) Ask the client to snap a rubber band worn on the wrist to minimize anxiety when thinking about the phobia:
Snapping a rubber band on the wrist is a distraction technique that might provide temporary relief from anxiety. However, it is not a core component of systematic desensitization, which focuses on gradual exposure and the use of relaxation techniques to manage anxiety

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Correct Answer is D

Explanation

A) Irrigate the affected ear with hydrogen peroxide: Irrigating the ear with hydrogen peroxide is not recommended post-myringotomy. This can cause irritation or infection at the surgical site, which could impede healing and potentially worsen the condition.

B) Drink liquids through a straw: Drinking liquids through a straw can create pressure changes in the ear, which is not advisable post-myringotomy. These pressure changes might affect the healing process of the ear.

C) Swimming is permitted after 1 week: Swimming is typically restricted for a longer period post-myringotomy to prevent water from entering the ear, which can lead to infection or interfere with the healing process.

D) Air travel is allowed after 3 weeks: Air travel restrictions are generally recommended for a few weeks post-myringotomy due to pressure changes that occur during flight, which can affect the ear's healing process. Waiting for 3 weeks allows the surgical site to heal sufficiently, reducing the risk of complications from pressure changes.

A. Keep client in semi-Fowler's position with right extremity flat. B. Manage pain with oral opioids every 6 hr. C. Check capillary refill hourly for the first 24 hr. D. Apply a compression dressing over the fracture site.

Correct Answer is D

Explanation

A) Keep client in semi-Fowler's position with right extremity flat: Keeping the client in a semi-Fowler's position with the extremity flat is not appropriate for managing a compound fracture. Elevating the affected limb, if possible, helps reduce swelling and pain, but the position should also consider overall stability and comfort.

B) Manage pain with oral opioids every 6 hr: Oral opioids are not the best choice for immediate pain management in an emergency setting, especially with a compound fracture. Intravenous pain medications are typically more effective for acute, severe pain in such situations and can provide quicker relief.

C) Check capillary refill hourly for the first 24 hr: Checking capillary refill is important to assess blood flow and perfusion, but hourly checks for 24 hours may not be necessary and can be overly frequent unless specific concerns arise. Monitoring should be based on clinical judgment and the client's condition.

D) Apply a compression dressing over the fracture site: Applying a compression dressing over the fracture site can help control bleeding and stabilize the area. Compound fractures involve an open wound, so controlling bleeding while minimizing the risk of infection is crucial. This intervention is essential in managing the initial trauma before more definitive surgical treatment.

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