A practical nurse (PN) is co-leading a group activity on an inpatient psychiatric unit. A client suddenly stands up, begins hyperventilating, grips their chest, and says, "I am having a heart attack and I am going to die!" Medical causes have been previously ruled out, and the PN recognizes an acute panic attack. In what order should the PN perform the following actions? Arrange the interventions in the correct sequence from first to last.
- 1Remain with the client and project a calm, reassuring demeanor.
- 2Escort the client away from the group to a quiet, low-stimulus environment.
- 3Communicate with the client using short, simple, and direct phrases.
- 4Coach the client to perform slow, deep breathing exercises.
- 5Document the client's behaviors, the interventions used, and the response.
Answer
The correct sequence of actions is: 1) Remain with the client, 2) Escort to a quiet environment, 3) Communicate with short phrases, 4) Coach deep breathing, and 5) Document the event.
When managing an acute panic attack, prioritizing safety and immediate presence is paramount. The nurse first stays with the client to ensure safety, then alters the environment by removing them from high stimuli. Next, communication is adjusted to short, simple phrases because the client's perceptual field is severely narrowed. This clear communication paves the way to successfully coach physical interventions like deep breathing. Finally, post-crisis documentation is completed once the client is stable.
Step-by-Step Solution
Key Concept
Nursing Management of Acute Panic Attacks