A patient has not been sleeping well because he is worried about losing his job and not being able to support his family
The nurse takes the patient's vital signs and notes a pulse rate of 112 beats/min, respirations are 26 breaths/min, and his blood pressure is 166/88 instead his usual 110-120/76-84 range. Which nursing intervention or recommendation should be used first?
a. Go to sleep 30 to 60 minutes earlier each night to increase rest.
b. Relax by spending more time playing with his pet dog.
c. Slow and deepen breathing via use of a positive, repeated word.
d. Consider that a new job might be better than his present one.
ANS: C
The patient is responding to stress with increased arousal of the sympathetic nervous system, as evident in his elevated vital signs. These will have a negative effect on his health and increase his perception of being anxious and stressed. Stimulating the parasympathetic nervous system (i.e., Benson's relaxation response) will counter the sympathetic nervous system's arousal, normalizing these vital-sign changes and reducing the physiologic demands stress is placing on his body. Other options do not address his physiologic response pattern as directly or immediately.
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