Psychiatric Medications Q 21
Junnel, who is manic, but not yet on medication, comes to the drug treatment center. The nurse would not let this client join the group session because:
A. The client is disruptive.
B. The client is harmful to self.
C. The client is harmful to others.
D. The client needs to be on medication first.
Correct Answer: A. The client is disruptive.
Group activity provides too much stimulation, which the client will not be able to handle (harmful to self) and as a result will be disruptive to others. Decrease environmental stimuli (e.g., by providing a calming environment or assigning a private room). Helps decrease escalation of anxiety and manic symptoms.
Option B: Frequently assess client’s behavior for signs of increased agitation and hyperactivity. Early detection and intervention of escalating mania will prevent the possibility of harm to self or others, and decrease the need for seclusions.
Option C: 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. 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.
Option D: Chart, in nurse’s notes, behaviors; interventions; what seemed to escalate agitation; what helped to calm agitation; when as-needed (PRN) medications were given and their effect; and what proved most helpful. Staff will begin to recognize potential signals for escalating manic behaviors and have a guideline for what might work best for the individual client.