Personality and Mood Disorders Q 109
In a day treatment program, a manic client is creating considerable chaos, behaving in a dominating and manipulative way. Which nursing intervention is most appropriate?
A. Allow the peer group to intervene.
B. Describe acceptable behavior and set realistic limits with the client.
C. Recommend that the client is hospitalized for treatment.
D. Tell the client that his behavior is inappropriate.
Correct Answer: B. Describe acceptable behavior and set realistic limits with the client.
In this situation, it would be appropriate for the nurse to suggest alternative behaviors in place of unacceptable ones to help the client gain self-control. Maintain a consistent approach, employ consistent expectations, and provide a structured environment. Clear and consistent limits and expectations minimize the potential for the client’s manipulation of staff.
Option A: The peer group is not responsible for monitoring the client’s behavior. Decrease environmental stimuli (e.g., by providing a calming environment or assigning a private room). Helps decrease escalation of anxiety and manic symptoms.
Option C: The client’s behavior does not warrant hospitalization. Redirect agitation and potentially violent behaviors with physical outlets in an area of low stimulation (e.g., punching bag). Can help to relieve pent-up hostility and relieve muscle tension.
Option D: The client is told only what is unacceptable and is not given any alternatives. Remain neutral as possible; Do not argue with the client. The client can use inconsistencies and value judgments as justification for arguing and escalating mania.