The nurse is attempting to de-escalate a client who is becoming increasingly agitated on the unit. Which of the following interventions would be appropriate for this type of client? (SELECT ALL THAT APPLY)

Choice A Reason:

Wheezes are continuous, high-pitched, musical sounds that occur when air flows through narrowed or obstructed airways1. They can be heard during both inspiration and expiration and are commonly associated with conditions such as asthma, chronic obstructive pulmonary disease (COPD), and bronchitis. Wheezes are a key indicator of airway obstruction and require prompt medical attention to address the underlying cause.

Choice B Reason:

Rhonchi are low-pitched, continuous sounds that resemble snoring or gurgling. They are typically caused by secretions or obstructions in the larger airways. Unlike wheezes, rhonchi are not high-pitched and do not have a musical quality. They are often heard in conditions like chronic bronchitis and can sometimes be cleared with coughing.

Choice C Reason:

Fine crackles are discontinuous, high-pitched popping sounds heard during inspiration. They are caused by the sudden opening of small airways and alveoli that are collapsed or filled with fluid. Fine crackles are often associated with conditions such as pneumonia, heart failure, and pulmonary fibrosis. They are not continuous sounds and do not have the musical quality of wheezes.

Choice D Reason:

Vesicular sounds are normal breath sounds heard over most of the lung fields. They are soft, low-pitched, and rustling in quality during inspiration and are fainter during expiration. Vesicular sounds indicate normal, unobstructed airflow through the small airways and alveoli. They are not continuous or high-pitched and do not have a musical quality.

The correct answer is a.

Choice A Reason:

The statement “Biofeedback” is correct. Biofeedback is a technique that uses electronic monitoring devices to help individuals gain control over involuntary bodily functions such as heart rate, muscle tension, and blood pressure. During biofeedback sessions, sensors are attached to the body to measure physiological functions, and the feedback from these sensors helps clients learn to control their physical responses to stress. This method is particularly effective for managing conditions like chronic pain, anxiety, and hypertension.

Choice B Reason:

The statement “Acupuncture” is incorrect. Acupuncture is a traditional Chinese medicine practice that involves inserting thin needles into specific points on the body to balance the flow of energy or qi. While acupuncture can help manage stress and pain, it does not use electronic monitoring devices to provide feedback on physiological functions5. Instead, it relies on the practitioner’s skill and knowledge of acupuncture points and meridians.

Choice C Reason:

The statement “Reiki” is incorrect. Reiki is a form of energy healing that involves the practitioner placing their hands lightly on or just above the client’s body to channel healing energy. Reiki aims to promote relaxation, reduce stress, and support the body’s natural healing processes. However, it does not involve the use of electronic monitoring devices to provide feedback on physiological functions.

Choice D Reason:

The statement “Autogenic training” is incorrect. Autogenic training is a relaxation technique that involves self-suggestion and visualization to induce a state of relaxation and reduce stress. It focuses on creating sensations of warmth and heaviness in different parts of the body through repeated phrases and mental imagery. While effective for stress management, it does not use electronic monitoring devices to provide feedback on physiological functions.