Comprehensive exams for Mental Health Q 161
Terry with mania is skipping up and down the hallway practically running into other clients. Which of the following activities would the nurse in charge expect to include in Terry’s plan of care?
A. Watching TV
B. Cleaning dayroom tables
C. Leading group activity
D. Reading a book
Correct Answer: B. Cleaning dayroom tables
The client with mania is very active & needs to have this energy channeled in a constructive task such as cleaning or tidying the room. Mania, or a manic phase, is a period of 1 week or more in which a person experiences a change in normal behavior that drastically affects their functioning. Mania is different from hypomania because hypomania does not cause a major deficit in social or occupational functioning, and it is a period of at least 4 days rather than 1 week. The defining characteristics of mania are increased talkativeness, rapid speech, decreased the need for sleep (unlike depression or anxiety in which the need for sleep exists, but there is an inability to sleep), racing thoughts, distractibility, increase in goal-directed activity, and psychomotor agitation.
Option A: Maintain a low level of stimuli in the client’s environment (e.g., loud noises, bright light, low-temperature ventilation). Helps minimize the escalation of anxiety. Provide structured solitary activities with the assistance of a nurse or aide. Structure provides focus and security.
Option C: Provide frequent rest periods to prevent exhaustion. Acute mania might warrant the use of phenothiazines and seclusions to decrease any physical harm. Exhaustion and death result from dehydration, lack of sleep, and constant physical activity.
Option D: When less manic, the client might join one or two other clients in quiet, non-stimulating activities (e.g., drawing, board games, cards). As mania subsides, involvement in activities that provide a focus and social contact becomes more appropriate. Competitive games can stimulate aggression and can increase psychomotor activity.