A nurse is assisting with the plan of care for a client who is in the manic phase of bipolar disorder.
Which of the following interventions should the nurse recommend to include?

Encourage group activities

Encourage short rest periods throughout the day

Provide a stimulating environment

Schedule daily seclusion times

Answer and Explanation

The Correct Answer is B

Choice A rationale:

While group activities can be beneficial for some clients with bipolar disorder, they may not be appropriate during a manic phase. This is because group settings can be overstimulating and overwhelming for individuals experiencing mania. The increased activity and social interaction can exacerbate symptoms such as racing thoughts, pressured speech, and impulsivity.

It's crucial to prioritize calming activities and minimize external stimuli during manic episodes.

Choice C rationale:

Providing a stimulating environment is not recommended for clients in the manic phase of bipolar disorder. A stimulating environment can worsen symptoms of mania, such as:

Increased energy and activity levels

Racing thoughts

Impulsivity

Distractibility

Risk-taking behavior

Irritability

Aggression

Decreased need for sleep Grandiose thinking

Poor judgment

Hypersexuality

A calm and structured environment is more conducive to managing manic symptoms.

Choice D rationale:

Scheduling daily seclusion times is not a standard intervention for clients in the manic phase of bipolar disorder. Seclusion is a restrictive intervention that should only be used as a last resort when a client is at risk of harming themselves or others. It's essential to explore less restrictive alternatives for managing manic symptoms, such as medication, therapy, and environmental modifications.

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Correct Answer is C

Explanation

A rationale:

Going to another room and reading for 20 minutes when waking up at night is a recommended strategy for managing insomnia. This technique helps to break the cycle of lying in bed awake and worrying, which can worsen insomnia. Reading can be a relaxing activity that can help to promote sleepiness. It's important to choose a book that is not too stimulating and to avoid reading in bright light.

Choice B rationale:

Stopping napping in the afternoon is also a recommended strategy for managing insomnia. Napping can interfere with nighttime sleep by reducing sleep drive. It's best to avoid napping altogether or to limit naps to 30 minutes or less early in the afternoon.

Choice C rationale:

Watching television in the bedroom is not recommended for managing insomnia. The light from the television can suppress the production of melatonin, a hormone that helps to regulate sleep. The noise from the television can also be stimulating and make it difficult to fall asleep. It's best to avoid watching television in the bedroom or to turn off the television at least 30 minutes before bedtime.

Choice D rationale:

Eating the evening meal at least 3 hours before bed is generally a good practice for sleep hygiene. Eating too close to bedtime can lead to indigestion, which can make it difficult to fall asleep. It's best to avoid heavy, fatty, or spicy foods before bed.

A. “You really should work hard to stay on the schedule we establish here.” B. “I wouldn’t worry about what you’ve done in the past. C. You’ll do just fine this time.” D. “Why do you find it difficult to take your medications if they improve your condition?”

Correct Answer is D

Explanation

The correct answer is Choice D.

Choice A rationale: Telling the client to work hard to stay on the schedule does not address the underlying reasons for the client's difficulty in following a medication regimen and may come off as dismissive.

Choice B rationale: Saying not to worry about the past does not acknowledge the client's concerns and may not provide practical assistance for future adherence.

Choice C rationale: Offering reassurance without addressing the client's past challenges does not provide a concrete plan for improving adherence.

Choice D rationale: Asking the client why they find it difficult to take medications opens a dialogue that allows the nurse to understand the client's specific barriers and to provide tailored strategies to improve adherence. This response is empathetic and solution-focused.

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A nurse is assisting with the plan of care for a client who is in the manic phase of bipolar disorder. Which of the following interventions should the nurse recommend to include?

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A nurse is assisting with the plan of care for a client who is in the manic phase of bipolar disorder.
Which of the following interventions should the nurse recommend to include?