A nurse is planning care for a client who has bipolar disorder and is experiencing mania.
Which of the following interventions should the nurse include in the plan?

Place the client in seclusion when he exhibits signs of anxiety.

Encourage the client to spend time in the dayroom.

Encourage the client to take frequent rest periods.

Withdraw the client's TV privileges if he does not attend group therapy.

Answer and Explanation

The Correct Answer is C

A.   Incorrect. Placing the client in seclusion is not an appropriate intervention for managing mania.
B.   Incorrect. Encouraging the client to spend time in the dayroom may exacerbate symptoms of mania by providing more stimulation.
C.   Correct. Encouraging the client to take frequent rest periods helps prevent overactivity and exhaustion, common in manic episodes.
D.   Incorrect. Withdrawing privileges are not directly related to managing manic symptoms and may not be therapeutic.

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Correct Answer is A

Explanation

A. Using an electronic messaging system to remind clients when to take medications is an example of tertiaryprevention, as it aims to prevent the development of complications.
B. Helping clients understand health screenings covered by their insurance plans can be considered primary or secondary prevention, depending on the context.
C. Incorrect. Providing clients with information about the benefits of exercise is an example of health promotion, which is also a component of primary prevention.
D. Educating clients about contraindications to specific immunizations falls under tertiary prevention, which aims to minimize the impact of an illness or condition that is already present.

A. Take on an empty stomach. B. Schedule dosage at bedtime. C. Increase dietary calcium. D. Monitor for weight loss.

Correct Answer is C

Explanation

A. Prednisone should generally be taken with food or after a meal to reduce the risk of gastric irritation or ulcer formation. Taking it on an empty stomach can irritate the stomach lining and increase the risk of gastrointestinal side effects, such as gastritis or peptic ulcers.

B. While some medications are best taken at bedtime (such as those with sedative effects), prednisone is a corticosteroid that can affect the body's circadian rhythm and may interfere with sleep. It typically causes insomnia or restlessness, so it’s usually advised to take it in the morning.

C. Prednisone and other corticosteroids can lead to bone loss (osteoporosis) over time, especially with long-term use. One of the side effects of corticosteroid therapy is decreased calcium absorption and bone density loss, making individuals at higher risk for fractures.

D. Prednisone more commonly causes weight gain rather than weight loss. Corticosteroids increase appetite and can lead to fluid retention, both of which can result in weight gain. Additionally, prednisone can cause redistribution of fat, often leading to characteristic side effects like "moon face" or increased abdominal fat.

B. Incorrect. Prednisone is often prescribed as a single daily dose in the morning to coincide with the body's natural cortisol release.

C. Incorrect. While calcium supplementation might be necessary for some individuals on long-term prednisone therapy, it is not a primary instruction related to taking prednisone.

D. Correct. Monitoring for weight loss is important due to the potential for weight changes (both weight gain and weight loss) as a result of prednisone's effects on metabolism and appetite.

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A nurse is planning care for a client who has bipolar disorder and is experiencing mania. Which of the following interventions should the nurse include in the plan?

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A nurse is planning care for a client who has bipolar disorder and is experiencing mania.
Which of the following interventions should the nurse include in the plan?