A nurse is planning care for an adolescent who is being admitted to an acute care unit following a suicide attempt. Which of the following interventions should the nurse identify as the priority?

Choice A reason: The belief that clients who talk about suicide are less likely to attempt it is a myth. Verbalizing suicidal ideation often reflects severe distress and heightened risk, as it may indicate prefrontal cortex dysfunction and impaired impulse control. This misconception underestimates the neurobiological basis of suicidal behavior, requiring vigilant assessment.

Choice B reason: Assuming clients who fail a suicide attempt will not try again is incorrect. Previous attempts increase future risk, as suicidal behavior is linked to persistent psychological distress and serotonin dysregulation. This assumption ignores the chronicity of underlying conditions like depression, necessitating ongoing monitoring and intervention to prevent recurrence.

Choice C reason: Claiming failed suicide attempts indicate a lack of intent to die is false. Many attempts fail due to external factors, not lack of intent. Suicidal behavior reflects complex neurobiological factors, including serotonin imbalance and prefrontal cortex deficits, requiring serious intervention regardless of outcome, as intent persists in high-risk individuals.

Choice D reason: A specific suicide plan indicates high risk, as it reflects advanced ideation and intent, often linked to prefrontal cortex dysfunction and reduced impulse control. Detailed planning suggests the client has visualized the act, increasing likelihood of completion. This principle guides nursing care to prioritize safety and immediate psychiatric intervention.

Choice A reason: Understanding the medication regimen is important for long-term bipolar management, stabilizing mood via dopamine and serotonin modulation. In acute mania, however, hyperactivity and reduced intake increase dehydration risk, which exacerbates cerebral dysfunction. Hydration is a more immediate physiological need than cognitive understanding during an acute episode.

Choice B reason: Acute mania in bipolar disorder involves hyperactivity and reduced self-care, driven by dopamine dysregulation, leading to dehydration. This impairs cerebral perfusion and electrolyte balance, risking seizures or organ damage. Maintaining hydration is the priority, as it stabilizes physiological function, supporting neural recovery during the acute manic phase.

Choice C reason: Practicing problem-solving skills aids long-term bipolar management by enhancing prefrontal cortex function. In acute mania, however, impaired insight and hyperactivity from dopamine excess limit cognitive engagement. Dehydration poses a greater immediate risk to cerebral and systemic stability, making this goal secondary during an acute episode.

Choice D reason: Identifying relapse indications supports long-term bipolar management by recognizing dopamine-driven mood shifts. In acute mania, immediate physiological risks like dehydration from hyperactivity take precedence, as they threaten cerebral and systemic stability. This goal is less urgent, as it addresses future prevention rather than current physiological needs.