A patient who has been unable to leave his home for more than a month because of symptoms of severe anxiety tells the nurse,"I know it's probably crazy,but I just can't bring myself to leave my apartment alone." An appropriate nursing intervention for the nurse to include in the initial nursing care plan is:

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This intervention,a form of cognitive restructuring,replaces negative thoughts such as "I can't leave my apartment" with positive thoughts such as "I am scared but I know that I am safe despite my fear,and if I do my deep breathing I can control my anxiety." This technique helps the patient gain mastery over his symptoms.A person unable to leave his home would be unable to access support groups or other treatment in the community.Pointing out the irrationality of his fears would be unproductive,since the patient is already aware of their irrationality.This awareness alone is not enough to change the fear.Medications play an important role,but there are many other actions the patient can take to improve coping,and the medications alone are not likely to be as effective as they would be if combined with other efforts to decrease anxiety and enhance coping.

A Patient Who Has Been Unable to Leave His Home