Exhibits Complete the diagram by selecting the option choices to specify the two most immediate actions the nurse should take, the condition the client is most likely experiencing, and two parameters the nurse should monitor to assess the client's progress.

Rationale for correct condition Post-traumatic stress disorder (PTSD) is the correct condition because the client experienced a traumatic motor vehicle accident. She reports persistent anxiety, insomnia, and nightmares directly related to the trauma. Flashbacks and avoidance behaviors, such as inability to drive, are hallmark features of PTSD. Guilt regarding her family member’s injury further supports the diagnosis. The symptoms have persisted for more than one month, meeting the diagnostic criteria. Rationale for the two correct actions Stay with the patient during periods of flashbacks and nightmares: This action provides therapeutic presence, reassurance, and safety during acute distress episodes. It helps reduce anxiety and prevents escalation of symptoms. Complete a referral for dialectical behavior therapy: This evidence-based therapy supports emotional regulation, distress tolerance, and trauma processing. It is appropriate for long-term management of PTSD and improves coping strategies. Rationale for parameters to monitor Prevalence of nightmares and quality of sleep: Sleep disturbance is a core symptom of PTSD. Monitoring frequency and severity of nightmares helps evaluate treatment effectiveness. Whether the patient can sleep without medication: Assessing ability to sleep naturally indicates progress in symptom management and reduction of reliance on sedatives. Rationale for incorrect conditions Grief: While guilt is present, the predominant symptoms are trauma-related flashbacks and nightmares, not normal grief. Generalized anxiety disorder: Anxiety is present, but it is specifically linked to trauma triggers, not generalized across situations. Obstructive sleep apnea: The client’s sleep disturbance is due to nightmares and anxiety, not airway obstruction. Rationale for incorrect actions to take Administer alprazolam (Xanax): Benzodiazepines are not first-line for PTSD due to risk of dependence and poor long-term outcomes. Assign different or new staff as often as possible: This disrupts continuity of care and increases patient anxiety. Administer lithium 200 mg PO bid: Lithium is indicated for bipolar disorder, not PTSD, and unnecessary here. Rationale for incorrect parameters to monitor Blood pressure and temperature: These are not primary indicators of PTSD progression, though vital signs may show transient changes. Complete blood count (CBC): No hematologic disorder is suspected, so monitoring CBC is irrelevant. Level of lithium in blood: Lithium is not prescribed, making this parameter inappropriate.