A nurse is planning overall strategies to address problems for a client who has borderline personality disorder. Which of the following strategies is the priority for the nurse to incorporate in the plan of care?

A. Implement measures to prevent intentional self-inflicted injury:
This choice is the priority. Individuals with borderline personality disorder are at an increased risk of self-harm and suicidal behaviors. Implementing measures to prevent intentional self-inflicted injury, such as close monitoring, removing potentially harmful objects, and creating a safe environment, is crucial to ensuring the client's safety and well-being.

B. Discuss the appropriate use of assertive behavior with the client:
Teaching assertive behavior is an important aspect of therapy for individuals with borderline personality disorder. Learning to express emotions and needs in a healthy, assertive manner can improve their interpersonal skills and relationships. However, this choice is secondary to ensuring the client's safety. Safety concerns need to be addressed before moving on to other therapeutic interventions.

C. Encourage the client to attend weekly support group meetings:
Support group meetings can provide valuable social support and a sense of belonging for individuals with borderline personality disorder. Being part of a supportive community can offer understanding and coping strategies. While this is a beneficial intervention, it is not the priority. Safety concerns and addressing self-harm risk take precedence.

D. Assist the client to maintain awareness of her thoughts and feelings:
Developing self-awareness and emotional regulation skills is essential in managing borderline personality disorder. Techniques such as mindfulness and dialectical behavior therapy (DBT) can help individuals become more aware of their thoughts and emotions. While important for long-term management, this intervention is not the priority when immediate safety concerns are present. Safety should always be the first focus of care.

A. Reduced frequency of panic attacks:
ECT is not primarily used to treat panic attacks. It is more commonly employed for severe mood disorders such as major depressive disorder and bipolar disorder. While ECT might indirectly affect anxiety symptoms, its main focus is on mood stabilization and improvement of depressive symptoms.

B. Decreased feelings of hopelessness:
This is the correct choice. Decreased feelings of hopelessness, often accompanied by improved mood and reduced suicidal thoughts, indicate the effectiveness of ECT in treating severe depression. ECT is known for its rapid and significant impact on mood, leading to improvements in feelings of hopelessness and despair, which are common symptoms of severe depression.

C. Reduced frequency of seizures:
ECT itself induces controlled seizures under anesthesia as part of the treatment process. The goal of ECT is not to reduce seizures but to target specific mental health conditions, particularly severe mood disorders. ECT is not indicated for managing epilepsy or reducing the frequency of seizures related to neurological disorders.

D. Decreased fear of heights:
ECT is not a treatment specifically designed to address phobias or fear-related disorders such as acrophobia (fear of heights). It is primarily used for severe mental health conditions, especially mood disorders. While an individual's overall anxiety might improve with successful ECT treatment, its direct effect on specific phobias like fear of heights is not a primary indication for the therapy.