Psychiatric Medications Q 47
Nurse Jen is caring for a male client with manic depression. The plan of care for a client in a manic state would include:
A. Offering high-calorie meals and strongly encouraging the client to finish all food.
B. Insisting that the client remain active through the day so that he’ll sleep at night.
C. Allowing the client to exhibit hyperactive, demanding, manipulative behavior without setting limits.
D. Listening attentively with a neutral attitude and avoiding power struggles.
Correct Answer: D. Listening attentively with a neutral attitude and avoiding power struggles.
The nurse should listen to the client’s requests, express willingness to seriously consider the request, and respond later. The nurse shouldn’t try to restrain the client when he feels the need to move around as long as his activity isn’t harmful. 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. Maintain a consistent approach, employ consistent expectations, and provide a structured environment. Clear and consistent limits and expectations minimize the potential for client’s manipulation of staff.
Option A: High-calorie finger foods should be offered to supplement the client’s diet, if he can’t remain seated long enough to eat a complete meal. The nurse shouldn’t be forced to stay seated at the table to finish a meal. Provide frequent high-calorie fluids (e.g., fruit shake, milk). Prevents the risk of serious dehydration.
Option B: The nurse should encourage the client to take short daytime naps because he expends so much energy. Provide frequent rest periods to prevent exhaustion. 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.
Option C: The nurse should set limits in a calm, clear, and self-confident tone of voice. Use a calm and firm approach. Provides structure and control for a client who is out of control. Use short, simple, and brief explanations or statements. A short attention span limits understanding to small pieces of information. 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.