A nurse is providing interventions for a client with panic disorder. Which interventions should the nurse include in the plan of care? (Select all that apply)

Choice A rationale:

"I should avoid medications that increase serotonin levels in the brain." While avoiding medications that increase serotonin levels is relevant in some cases, it's not a comprehensive understanding of pharmacological treatment for panic disorder. Serotonin-related medications like selective serotonin reuptake inhibitors (SSRIs) are commonly used for panic disorder treatment.

Choice B rationale:

"Antihypertensives can help reduce physical symptoms of panic attacks." This statement is not accurate. Antihypertensives are not commonly used to treat panic disorder. Medications like beta-blockers may be prescribed to manage some physical symptoms of anxiety, but they are not a primary treatment for panic disorder.

Choice C rationale:

"Antiepileptics can enhance the effects of gamma-aminobutyric acid (GABA) in the brain." This is the correct choice. Antiepileptic medications like pregabalin and gabapentin can indeed enhance the effects of GABA, an inhibitory neurotransmitter that helps reduce anxiety and panic. These medications are sometimes used to manage panic disorder symptoms.

Choice D rationale:

"Tricyclic antidepressants inhibit the reuptake of norepinephrine in the brain." While tricyclic antidepressants have been used historically to treat panic disorder, they are not considered first-line treatments due to their potential side effects and the availability of newer, safer options. The statement in Choice D is accurate but not as relevant to current treatment approaches.

Choice A rationale:

Providing a safe and calm environment for the client during a panic attack is crucial to help minimize distress and prevent harm. Panic attacks can lead to heightened anxiety and fear, and creating a safe space can help the client feel secure. This intervention aids in reducing the overall intensity and duration of the panic attack.

Choice B rationale:

Using therapeutic communication skills to establish rapport and trust with the client is essential in managing panic disorder. By employing active listening, empathy, and non-judgmental responses, the nurse can create a supportive environment. Building a therapeutic relationship enhances the client's willingness to communicate, share their experiences, and adhere to the treatment plan.

Choice C rationale:

Educating the client about panic disorder and its treatment options is important, but it might be overwhelming during a panic attack. Providing education can be more effective when the client is relatively stable and receptive. The immediate focus during a panic attack should be on providing comfort and support.

Choice D rationale:

Encouraging the client to participate in cognitive-behavioral therapy (CBT) is a valuable intervention for panic disorder. However, suggesting this during a panic attack might not be appropriate, as the client's focus and ability to engage in a discussion could be compromised. It's better to introduce the idea of CBT when the client is in a more receptive state.

Choice E rationale:

Referring the client to self-help groups for peer support and education is also a beneficial intervention. However, during a panic attack, the client may not be open to the idea of group involvement. This recommendation is better suited for a calmer moment when the client can consider it more rationally.