Anxiety Disorders and Stress Q 17
David is preoccupied with numerous bodily complaints even after a careful diagnostic workup reveals no physiologic problems. Which nursing intervention would be therapeutic for him?
A. Acknowledge that the complaints are real to the client, and refocus the client on other concerns and problems.
B. Challenge the physical complaints by confronting the client with the normal diagnostic findings.
C. Ignore the client's complaints, but request that the client keeps a list of all symptoms.
D. Listen to the client's complaints carefully, and question him about specific symptoms.
Correct Answer: A. Acknowledge that the complaints are real to the client, and refocus the client on other concerns and problems.
After physical factors are ruled out, somatic complaints are thought to be expressions of anxiety. The complaints are real to the client, but the nurse should not focus on them. Prompting the client about other concerns will encourage the expression of anxiety and dependency needs. The nurse must help the client establish a daily routine that includes improved health behaviors. Provide accommodation for the client and make them more comfortable (ie., pillows, temperature, positioning, etc.). This can help the client feel accepted and develop rapport and trust. This can allow the client to feel more comfortable and express their feelings and emotions more readily to the healthcare team.
Option B: Clients may keep a detailed journal of their physical symptoms; the nurse might ask them to describe the situation at the time such as whether they were alone or with others, whether any disagreements were occurring, and so forth. Provide education about feared or actual medical conditions. This can help relieve acute pain and distress that the client may feel, but also helps them learn to control many symptoms through focus and calming the mind.
Option C: Encourage behavior modification such as praising the client and offering more attention when symptoms improve. Change the focus from what’s wrong to what’s right. Helps the client feel accomplished and more positive about improvements in health condition instead of focusing on the symptoms. Encourage the client to keep a journal of symptoms and the events or factors that lead up to the development of symptoms and their resolution. This is a technique of cognitive behavior therapy that helps the client understand what factors (usually stress) that prompt the onset of symptoms. It can also help the client determine a pattern of emotions surrounding the symptoms.
Option D: Discuss symptoms with the client and when they began, what makes them better or worse and how they have been managing these symptoms. Teach coping strategies. Emotion-focused strategies include progressive relaxation, deep breathing, guided imagery, and distractions such as music or other activities; problem-focused coping strategies include problem-solving methods, applying the process to identified problems, and role-playing interactions with others.