Michelle complains to the night nurse that the staff on the day shift don't like her. She continues to tell the nurse that she is the best nurse on the unit because she is always caring and kind. The nurse informs Michele that she will be on vacation for the next week. An hour later. Michelle is found cutting her wrists with a plastic knife. Which personality disorder would you suspect Michelle has?

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.

A. Allow the client to pace alone until physically tired: While pacing can be a coping mechanism, leaving the client alone may not be the most therapeutic approach. It is important for the nurse to provide support and assess the client's emotional state.

B. Walk with the client at a gradually slower pace: This is the correct answer. Walking with the client at a gradually slower pace allows the nurse to offer support and engage in therapeutic communication. It provides a calming presence and can assist the client in self-regulating their anxiety.

C. Have a staff member escort the client to her room: Escorting the client to her room might be perceived as restrictive or punitive. It is generally more beneficial to engage in supportive interventions and encourage coping strategies.

D. Instruct the client to sit down and stop pacing: Giving direct orders to stop pacing may increase anxiety and may not be an effective approach. It is often better to engage in a supportive manner and explore ways to help the client manage their anxiety.