A client experiencing a panic attack is hyperventilating and says, 'I think I'm having a heart attack — I'm going to die.' After medical causes are ruled out, what is the most therapeutic nursing intervention?

PANIC ATTACK — ACUTE NURSING INTERVENTION: Once medical causes (cardiac, respiratory) are ruled out, the therapeutic approach is calm, supportive presence.

Interventions: STAY with the client (do not leave them alone — abandonment increases panic); remain CALM yourself (anxiety is contagious; calmness is reassuring); speak in SHORT, SIMPLE sentences (panic impairs processing of complex information); guide SLOW breathing (model it; breathe with them) to counteract hyperventilation; provide reassurance that they are safe and the symptoms will pass; reduce stimulation (quiet environment).

Avoid: Leaving them alone; dismissing their feelings ('nothing's wrong, relax' — invalidating); long explanations; high-flow oxygen (hyperventilation already causes respiratory alkalosis).

Panic attack: Peaks within 10 minutes, intense fear with physical symptoms (palpitations, chest pain, dyspnea, dizziness, sense of doom).

Longer-term: CBT, SSRIs, teaching coping/breathing techniques for future attacks; nursing role: calm supportive presence, guide breathing, reassure, ensure safety, never abandon during acute panic.