Psychiatric Assessment and Fundamentals Q 32
A nursing care plan for a male client with bipolar I disorder should include:
A. Providing a structured environment.
B. Designing activities that will require the client to maintain contact with reality.
C. Engaging the client in conversing about current affairs.
D. Touching the client provides assurance.
Correct Answer: A. Providing a structured environment
Structure tends to decrease agitation and anxiety and to increase the client’s feeling of security. Provide structured solitary activities with the assistance of a nurse or aide. Structure provides focus and security. Provide frequent rest periods to prevent exhaustion.
Option B: Maintain a low level of stimuli in the client’s environment (e.g., loud noises, bright light, low-temperature ventilation). This helps minimize the escalation of anxiety. 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 C: 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. Use short, simple, and brief explanations or statements. Short attention span limits understanding of small pieces of information.
Option D: Use a calm and firm approach; provide structure and control for a client who is out of control. 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.