Personality and Mood Disorders Q 47
Situation: A 27-year-old writer is admitted for the second time accompanied by his wife. He is demanding, arrogant, talks fast, and hyperactive. Initially, the nurse should plan this for a manic client:
A. Set realistic limits to the client’s behavior.
B. Repeat verbal instructions as often as needed.
C. Allow the client to get out feelings to relieve tension.
D. Assign a staff to be with the client at all times to help maintain control.
Correct Answer: A. Set realistic limits to the client’s behavior
The manic client is hyperactive and may engage in injurious activities. A quiet environment and consistent and firm limits should be set to ensure safety. 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 B: Clear, concise directions are given because of the distractibility of the client but this is not the priority. Use short, simple, and brief explanations or statements. A short attention span limits understanding to small pieces of information.
Option C: The manic client tends to externalize hostile feelings, however only non-destructive methods of expression should be allowed. 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: Nurses set limits as needed. Assigning staff to be with the client at all times is not realistic. Decrease environmental stimuli (e.g., by providing a calming environment or assigning a private room). Helps decrease the escalation of anxiety and manic symptoms.