A nurse is counseling a client for the management of anxiety. The client is consistently late for appointments and ignores household chores. The client states, "I'm just too stressed. I need someone to take care of me." The nurse identifies this behavior as an example of which of the following defense mechanisms?

A. A semi-private room with a roommate who has a similar diagnosis. Placing a client experiencing a manic episode in a semi-private room with another client who also has a similar diagnosis could potentially exacerbate symptoms or lead to conflict. Manic clients may have increased energy levels, impulsivity, and decreased need for sleep, which could disrupt the roommate's rest and compromise their safety.

B. A private room close to the nursing station. Assigning a private room close to the nursing station is the most appropriate option for a client in the manic phase of bipolar disorder. This allows for closer monitoring and supervision by nursing staff, as well as easier access for interventions and assistance when needed. It also helps to minimize stimulation and provide a more controlled environment for the client.

C. A private room in a quiet location on the unit. While a quiet location may be beneficial for some clients, a private room close to the nursing station offers better access to supervision and support from staff, which is particularly important for clients experiencing mania. Additionally, a quiet location may not always be feasible in a busy psychiatric unit.

D. A seclusion room until the client's activity level becomes more subdued. Using a seclusion room should only be considered as a last resort and when absolutely necessary to ensure the safety of the client and others. It should not be the first choice for a client in the manic phase of bipolar disorder. Placing the client in seclusion may further escalate agitation and increase feelings of isolation and distress.

Lithium toxicity is a significant concern for clients taking lithium, a mood stabilizer commonly prescribed for bipolar disorder. Diarrhea can lead to dehydration and electrolyte imbalances, which can increase lithium levels in the blood, potentially leading to toxicity. Therefore, cautioning against experiencing diarrhea is essential in discharge teaching for clients prescribed lithium.

Option A is correct because it identifies a factor that can contribute to lithium toxicity. Diarrhea can lead to fluid and electrolyte imbalances, affecting lithium levels in the blood.

Option B, drinking green tea, is not typically associated with lithium toxicity. Green tea contains caffeine, but its consumption is not a significant risk factor for lithium toxicity.

Option C, exercising moderately, is generally encouraged for overall health and well-being. However, it does not directly relate to lithium toxicity unless excessive sweating leads to dehydration and electrolyte imbalances.

Option D, increasing sodium intake, is typically discouraged for clients taking lithium because high sodium levels can affect lithium reabsorption in the kidneys, potentially leading to increased lithium levels and toxicity. However, this option is not directly related to the question about factors causing lithium toxicity.