A paranoid client presents with bizarre behaviors, neologisms, and thought insertion. Which nursing action should be prioritized to maintain this clients safety?

A. "I can see that you are angry. Let's discuss ways to approach Peter with your concerns."

This response is empathetic and invites the client to discuss their concerns. However, it doesn't explicitly address the client's request for the nurse to take action. The more appropriate approach would involve the nurse taking direct responsibility for addressing the issue.

B. "Why are you overreacting to the issue?"

This response may be perceived as dismissive and judgmental. It does not validate the client's concerns or address the issue constructively.

C. "You should bring this to the attention of your treatment team."

While involving the treatment team is important, the client has directly approached the nurse with a concern. It is appropriate for the nurse to take the initial step in addressing the issue directly rather than immediately redirecting the client to the treatment team.

D. "I'll talk to Peter and present your concerns."

This is the most appropriate response. It acknowledges the client's concerns, takes responsibility for addressing the issue, and ensures that the client's voice is heard. The nurse can discuss the matter with Peter and work towards a resolution.

While all the outcomes are important in the overall care of a client with bipolar disorder, the safety of the client takes precedence, especially during the acute phase of the disorder. Bipolar disorder is characterized by mood swings that can include episodes of mania, which may involve risky behaviors or even thoughts of self-harm.
A. The client will remain safe throughout hospitalization: This is the priority outcome. Ensuring the safety of the client during hospitalization involves monitoring for any signs of self-harm or harm to others, managing any acute manic or depressive symptoms, and providing a secure environment.

B. The client will accomplish activities of daily living independently by discharge: While independence in activities of daily living is a valuable outcome, it may not be the immediate priority during the acute phase of bipolar disorder. Addressing safety and stabilization come first.

C. The client will use problem-solving to cope adequately after discharge: Coping skills are important for long-term management, but ensuring safety and stabilization during the hospitalization phase takes precedence. Coping skills can be addressed as part of the overall treatment plan.

D. The client will verbalize feelings during group sessions by discharge: Expression of feelings is an important aspect of mental health treatment, but safety and stabilization remain the priority, especially during the acute phase of bipolar disorder.