A nurse is discussing discipline techniques with the parent of a pre-schooler. Which of the following statements by the parent indicates an understanding of time-out as a form of discipline?

Potassium level is critically low at 2.8 mEq/L, which places the client at risk for life-threatening cardiac arrhythmias. Hypokalemia is common in clients with eating disorders due to malnutrition, laxative misuse, and electrolyte imbalances. Since low potassium can cause cardiac complications, this should be prioritized over other concerns.

Checking an EKG is the appropriate action because hypokalemia can lead to dangerous arrhythmias, including prolonged QT interval and ventricular dysrhythmias. An EKG will help assess for any immediate cardiac risks and guide the need for potassium replacement therapy.

Anxiety – Assessing the Hamilton Anxiety Scale. Although the client reports anxiety, it is not the most immediate concern. While the Hamilton Anxiety Scale is useful for evaluating anxiety severity, the nurse should first focus on correcting the critical electrolyte imbalance before assessing mental health symptoms.

Caloric intake – Administering liquid supplements. Restoring adequate nutrition is important for the long-term treatment of anorexia, but electrolyte imbalances must be corrected first to prevent cardiac complications. Feeding a malnourished client too quickly without stabilizing electrolytes could lead to refeeding syndrome, which can be fatal.

Alcohol use – Having the client complete a CAGE questionnaire. The client’s reported alcohol consumption (3-4 glasses of wine per night) is concerning, but it does not pose an immediate life-threatening risk compared to hypokalemia. Evaluating for alcohol dependence should be done after addressing the urgent medical concerns.

Body mass index – Observing the client during meals. The client’s BMI of 15.4 kg/m² confirms severe malnutrition, but meal monitoring is not the first priority. Before increasing food intake, electrolytes must be stabilized to prevent complications such as refeeding syndrome.

A. Grandiosity. Clients experiencing mania often exhibit inflated self-esteem or a sense of superiority, believing they have exceptional abilities, wealth, or power. This exaggerated confidence is a hallmark symptom of bipolar mania.
B. Flight of ideas. Rapid, continuous speech with abrupt topic changes is common in mania. Clients may jump from one idea to another without logical connections, making their speech difficult to follow. This is known as flight of ideas and reflects their racing thoughts.
C. Spitting. While agitation and impulsivity are common in mania, spitting is not a specific or expected symptom. Clients may exhibit verbal aggression or inappropriate behaviors, but spitting is not a defining feature of mania.
D. Hyperactivity. Mania is characterized by excessive energy, restlessness, and an inability to stay still. Clients often engage in reckless behaviors, have decreased need for sleep, and struggle with impulse control, contributing to hyperactivity.
E. Withdrawal. Social withdrawal is more characteristic of depressive episodes rather than mania. In contrast, manic individuals are often highly sociable, intrusive, and overly talkative, sometimes to the point of disrupting social norms.