Substance Abuse and Abuse Q 30
Which of the following communication guidelines should the nurse use when talking with a client experiencing mania?
A. Address the client in a light and joking manner.
B. Focus and redirect the conversation as necessary.
C. Allow the client to talk about several different topics.
D. Ask only open ended questions to facilitate conversations.
Correct Answer: B. Focus and redirect the conversation as necessary
To decrease stimulation, the nurse should attempt to redirect and focus the client’s communication, not allow the client to talk about different topics. Maintain a consistent approach, employ consistent expectations, and provide a structured environment. Clear and consistent limits and expectations minimize potential for client’s manipulation of staff. Use a calm and firm approach. Provides structure and control for a client who is out of control.
Option A: By addressing the client in a light and joking manner, the conversation may contribute to the client’s feeling out of control. Use short, simple and brief explanations or statements. Short attention span limits understanding to small pieces of information. 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 C: 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. 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: For a manic client, it’s best to ask closed questions because open-ended questions may enable the client to talk endlessly, again possibly contributing to the client’s feeling out of control. Decrease environmental stimuli (e.g., by providing a calming environment or assigning a private room); helps decrease escalation of anxiety and manic symptoms.