When the patient begins to sob uncontrollably and her speech becomes so incoherent that she is unable to give the nurse any information, what will the immediate interventions focus on?

Choice A reason: Hospital admission may eventually be necessary, but it is not the immediate intervention for a patient currently experiencing an acute emotional outburst. The nurse must first stabilize the patient's physiological and psychological state before a proper assessment for the necessity of inpatient care can be performed. Choice B reason: Incoherent speech and uncontrollable sobbing indicate a severe or panic level of anxiety. At this level, the patient’s perceptual field is greatly diminished, and they cannot process information. The priority is to lower anxiety to a moderate level where communication and cognitive processing become possible again. Choice C reason: A patient in a state of severe anxiety or panic is cognitively unable to learn or identify new coping strategies. High levels of neurobiological arousal prevent the prefrontal cortex from functioning effectively. Coping strategies can only be discussed once the patient’s anxiety has been significantly reduced. Choice D reason: Contacting a support person is a secondary intervention. The immediate priority is the nurse’s presence and the use of calming techniques to stabilize the patient. Once the patient is coherent, the nurse can then collaborate with the patient to determine who should be contacted for support.