A patient with emphysema who has severe shortness of breath and frequent hospitalizations often depends on her portable oxygen tank when she leaves her home
Recently she has not been able to go upstairs to her bedroom at night because of shortness of breath and fear of developing severe breathing difficulty if she continues up the stairs. A support group leader suggests the use of guided imagery. What image would the patient be encouraged to visualize? a. Having a younger, healthier body that knows no exercise limitations
b. Walking up the stairs in a steady, relaxed manner, taking regular deep breaths
c. Walking up stairs slowly and steadily without using any supplemental oxygen
d. Sleeping comfortably and soundly downstairs, without respiratory distress
B
The patient has dysfunctional images of dyspnea and her ability to climb stairs. Guided imagery can help her replace the dysfunctional image with a positive coping image. Athletes have found that picturing successful images can enhance performance. Encouraging the patient to imagine a regular breathing depth and rate will help improve oxygen–carbon dioxide exchange and help her achieve further relaxation. Other options focus on unrealistic goals (being younger, not needing supplemental oxygen) or restrict her quality of life (sleeping downstairs rather than reducing her anxiety about stair climbing).
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