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 A

Explanation

A) "I'll use pursed-lip breathing when I feel short of breath.": Pursed-lip breathing is a beneficial technique for clients with COPD as it helps keep the airways open longer, reduces the work of breathing, and improves ventilation. This statement indicates the client understands a key management strategy for COPD.

B) "I'll skip my exercises for the week if I feel short of breath.": Regular exercise is important for managing COPD, and while adjustments may be necessary when symptoms are severe, completely skipping exercise can lead to deconditioning and worsening of symptoms. This statement does not reflect appropriate management of COPD.

C) "I will use my inhaler 30 minutes after each meal.": Inhalers should be used as prescribed, usually before activities that might trigger symptoms, such as eating, rather than on a fixed schedule unrelated to symptoms or physician's guidance. This statement indicates a misunderstanding of inhaler use.

D) "I will limit myself to drinking only 1 quart of water each day.": Staying hydrated is important for thinning mucus in COPD. Unless there are specific medical reasons to restrict fluids, such as heart failure, limiting water intake could lead to dehydration and thickened mucus, making breathing more difficult. This statement is not appropriate for managing COPD.

A. "Central vision loss is affected first." B. "Straining during a bowel movement can increase the progression of the disease C. "Plan to include high doses of Vitamin E in your diet." D. "Remove glasses before performing the Amsler grid test at home."

Correct Answer is A

Explanation

A) "Central vision loss is affected first.": This statement is accurate as macular degeneration primarily affects the macula, which is responsible for central vision. Clients with macular degeneration typically experience a loss of central vision first, which can severely impact activities such as reading, driving, and recognizing faces.

B) "Straining during a bowel movement can increase the progression of the disease.": This statement is not supported by evidence related to macular degeneration. While general health and avoiding strain are important, there is no specific connection between straining during bowel movements and the progression of macular degeneration.

C) "Plan to include high doses of Vitamin E in your diet.": Although antioxidants like Vitamin E can be beneficial for eye health, especially in the context of a balanced diet including other vitamins and minerals, there is no specific recommendation for high doses of Vitamin E alone to manage macular degeneration. The AREDS (Age-Related Eye Disease Study) formulation includes a combination of vitamins and minerals.

D) "Remove glasses before performing the Amsler grid test at home.": When using the Amsler grid test to monitor for changes in vision due to macular degeneration, clients should wear their glasses or contact lenses to ensure they are viewing the grid with their usual visual correction. This helps in accurately detecting any distortions or changes in vision.

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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?

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