A client 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 was tearful at a Better
Breathers Group meeting because in the last 2 weeks she has not been able to go upstairs to her
bedroom at night because of slight shortness of breath by the third step and fear of having severe
breathing difficulty as she continues up the stairs. The group leader provides several suggestions and
arranges to teach the client guided imagery. What image would the client be encouraged to imagine?
a. A younger, healthier body that knows no exercise limitations.
b. Learning to sleep downstairs as an acceptable alternative to her bedroom.
c. Separating herself from and being free and independent from her oxygen tank.
d. Walking up the stairs in a relaxed manner with regular depth and rate of
breathing.
ANS: D
The client 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 client to imagine a regular
breathing depth and rate will help improve oxygen–carbon dioxide exchange and help her achieve
further relaxation. Options A and C are not as closely related to the stated problem as option D.
Option B introduces an entirely different resolution.
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