During a follow-up visit, a patient reports worsening symptoms of PTSD after experiencing sexual violence. What steps should the nurse take next? (Select all that apply)

Choice A reason: Re-evaluating the treatment plan addresses worsening PTSD symptoms by assessing intervention efficacy. PTSD involves heightened amygdala activity and cortisol dysregulation. Scientifically, adjusting therapy or medication based on symptom progression ensures targeted management of neurobiological changes, reducing hyperarousal and improving emotional regulation for effective trauma recovery. Choice B reason: Increasing medication dosage without assessment risks adverse effects. PTSD medications, like SSRIs, require careful titration based on symptom severity. Scientifically, unguided increases may disrupt neurotransmitter balance, potentially worsening symptoms or causing side effects like agitation, without addressing specific trauma-related triggers or psychological needs. Choice C reason: Frequent follow-ups monitor PTSD symptom progression, ensuring timely interventions. Scientifically, regular assessments track amygdala-driven hyperarousal and cortisol levels, allowing adjustments to therapy or medication. This supports psychological stability, reduces relapse risk, and ensures ongoing care aligns with the patient’s evolving trauma-related needs. Choice D reason: Referring to a trauma therapist provides specialized interventions, like EMDR, tailored to PTSD. These therapies target trauma-related neural pathways, reducing intrusive memories and hyperarousal. Scientifically, expert care addresses complex psychological trauma, improving emotional regulation and recovery by processing traumatic memories in a controlled, therapeutic environment. Choice E reason: Avoiding triggers minimizes acute PTSD symptoms, like flashbacks, by reducing amygdala activation. Scientifically, trigger avoidance stabilizes emotional responses, preventing stress-induced cortisol spikes that exacerbate PTSD. This supports immediate psychological safety, allowing patients to engage in therapy more effectively while managing trauma-related hyperarousal.