MHQ2

Which antianxiety medication should the nurse expect will be prescribed to clients with acute mania?

Clonazepam

The nurse can most expect a client demonstrating typical manic behavior to be attired in what type of clothing?

Colorful and outlandish

Which body system is most at risk for decompensation during the acute phase of a severe manic episode?

Cardiac

Which assessment finding regarding communication is likely in a client experiencing acute mania?

Clang associations

Which behavior would be most characteristic of a client during a manic episode?

Switching rapidly from one activity to another

Which approach should the nurse use when communicating with a client experiencing an elated mood and euphoria?

Use a calm, firm approach.

A community mental health nurse counsels a group of clients about the upcoming flu season. What instruction does the nurse provide for clients who are prescribed lithium?

"Stop taking your medicine, and contact me if you develop nausea, vomiting, and/or diarrhea."

Which comment by a client diagnosed with bipolar disorder most indicates the client is experiencing mania?

"Yesterday I made 487 posts on my social network page."

A client was diagnosed with bipolar disorder many years ago. The client tells the nurse, "When I have a manic episode, there's always a feeling of gloom behind it, and I know I will soon be totally depressed." What is the nurse's most appropriate response?

"Your comment indicates you have an understanding and insight about your disorder."

Which client statements support the diagnosis of mania? Select all that apply.

- "I've telephoned everyone I know and talked for hours." - "I really don't need much sleep; 2 hours a night is enough." - "My friends all say this outfit is way too sexy, but I like it and wear it all the time." - "My family is really upset with me, but it's just because they're jealous of everything I do."

A client who is manic with rapid cycling manic symptoms is treated with carbamazepine. Which adverse effect should the nurse report to the health care provider for a client who is on continuous administration of this drug?

Bone marrow suppression

When a client taking lithium reports an upset stomach, how does the nurse suggest taking the medication?

With meals

What action should the nurse take upon learning that a manic client's serum lithium level is 1.8 mEq/L?

Withhold medication, and notify the health care provider.

What should the nurse monitor in clients who have bipolar disorder and have been administered divalproex sodium? Select all that apply.

- Liver function - Platelet count

Which change in behavior is important to include when teaching the client and the family to recognize possible signs of impending mania?

Decreased sleep

Which is a desired outcome for a client who is manic during the acute phase?

The client is free of injury.

A client diagnosed with bipolar disorder is showing early signs of mania. The client says, "I need to go visit my daughter but she lives across the country. I put some requests on the internet to get a ride. I'm sure someone will take me." What is the nurse's most therapeutic response?

"I'm concerned about your safety when meeting or riding with strangers."

A client diagnosed with bipolar disorder has taken lithium for 1 year with good results. Today, the client phones the nurse with multiple complaints. Which complaint should receive the nurse's priority attention?

"I've had very bad diarrhea for 3 days."

A client diagnosed with bipolar disorder has taken lamotrigine for 3 months with good results. Today, the client calls the nurse with multiple complaints. Which complaint should receive the nurse's priority attention?

"I've noticed a new rash on my chest and abdomen."

A client who is manic tells a nurse "Bud. Crud. Dud. I'm a real stud! You'd like what I have to offer. Let's go to my room." What would be the nurse's most appropriate response?

"It's time to work on your art project."

Which notations in the client's medical record support the diagnosis of mania? Select all that apply.

- Client reports, "God talks directly to me." - Client is disheveled and in need of a bath. - Client presents with a happy, nearly euphoric demeanor. - Client reports, "I haven't slept in 4 days; I don't need to."

A client diagnosed with bipolar disorder takes lithium. After playing soccer on a hot summer day, the client complains of nausea, vomiting, diarrhea, and thirst. The client's hands begin to tremble, and the gait becomes unsteady. Which are priority nursing interventions? Select all that apply.

- Instruct the client not to take any more lithium until directed by the health care provider. - Collaborate with the health care provider about drawing a serum lithium level immediately.

Which statements regarding therapy with lithium are true?

- It demonstrates effectiveness in the treatment of bipolar I. - Manic behaviors generally show improvement in 10 to 21 days. - Indeterminate maintenance dosing is required for many clients.

With a serum lithium level of 0.8 mEq/L, which assessment data does the nurse expect to observe? Select all that apply.

- Polyuria - Mild thirst - Fine hand tremors

A nurse is assisting a client who is manic in dressing and maintaining basic hygiene tasks. Which nursing interventions are appropriate for the client in a manic state? Select all that apply.

- Provide step-by-step instructions for dressing. - Provide simple clothes and hygiene tasks to the client. - Provide repeated reminders to finish tasks if necessary.

A client hospitalized with an acute manic episode shows progressive improvement with lithium therapy. At the time of discharge, what information should the nurse provide to the client and family? Select all that apply.

- "Schedule regular check-ups to test the function of your thyroid and kidney." - "Contact your primary health care provider if there is any excessive vomiting."

To best assure a client who is manic is well-hydrated, which assessments will the nurse perform? Select all that apply.

- Skin turgor - Urinary output -Skin integrity

A nurse prepares the plan of care for a client experiencing an acute manic episode. Which nursing diagnoses are most likely to apply? Select all that apply.

- Sleep deprivation - Disturbed thought processes - Imbalanced nutrition: less than body requirements

A nurse prepares the plan of care for a client having a manic episode. Which nursing diagnoses are most likely to apply? Select all that apply.

- Sleep deprivation - Disturbed thought processes - Risk for deficient fluid volume

A nurse caring for a client who is manic observes that the client has persistent gastrointestinal upset. The nurse expects that the client is showing advanced signs of lithium toxicity and expects the health care provider to test the serum levels of lithium in the client. Beyond which concentration of lithium does the nurse know indicates advanced signs of lithium toxicity?

1.8 mEq/L

A client diagnosed with bipolar disorder is in the continuation phase of treatment. Which of the following outcomes most applies to this phase?

Accurately stating indicators of relapse

A client diagnosed with bipolar disorder was hospitalized 15 days ago and has been receiving lithium. Current assessment findings include increased restlessness, pressured speech, and flight of ideas. The client sleeps 2 hours per night. What is the nurse's most appropriate intervention?

Consider the need to obtain a lithium level from the laboratory. The client may not be swallowing the medication.

Which clients does the nurse know can be safely prescribed lithium therapy to treat bipolar disorder?

Clients with erectile dysfunction

A client has a long history of bipolar disorder with frequent episodes of mania secondary to stopping prescribed medications. The client says, "I will use my whole check next month to buy lottery tickets. Winning will solve my money problems." Which is the nurse's most appropriate action?

Confer with the treatment team about appointing a legal guardian for the client.

Which action should the nurse take when managing a hospitalized client experiencing acute mania?

Encouraging frequent naps

The client treated with lithium carbonate repeatedly requests water to drink and has slurred speech. What is the priority nursing action in this case?

Evaluate the client's blood lithium level.

A client admitted with acute mania tells the staff and the other clients that he is on a secret mission given to him by the President of the United States to monitor citizens for terrorist activity. The client states "I am the only one he trusts, because I am the best!" For documentation purposes, which term describes this behavior?

Grandiosity

A client who is bipolar tells the nurse, "I have the finest tenor voice in the world. The three tenors who do all those television concerts are going to retire because they can't compete with me." What does the nurse document?

Grandiosity

The nurse cares for a client in the acute phase of bipolar disorder who has mania. This client annoys other clients, loudly engages in power struggles with staff, and taunts the housekeeping employees about their ability to clean. Which nursing diagnosis is most applicable?

Impaired social interaction

A client with mania reports an inability to sleep. What action does the nurse take to help the client sleep better?

Instruct the client to perform slow exercises.

What information concerning electroconvulsive therapy (ECT) treatment and its effectiveness for clients diagnosed with bipolar disorder is true?

It is promising for clients with a history of rapid cycling.

The first-line drug used to treat mania is

Lithium

The nurse is managing the care of an older adult diagnosed with bipolar disorder who is in a manic phase. The nurse closely monitors the client for risks to safety. Which factor most indicates this intervention for this client?

Mania can result in irresponsible and physically risky behaviors.

What should the plan of care for a client who takes lithium include?

Periodic laboratory monitoring of renal and thyroid function

When a client experiences four or more mood episodes in a 12-month period, what term does the nurse document?

Rapid cycling

Which is an acute-phase nursing intervention aimed at reducing hyperactivity for a client experiencing mania?

Redirecting the patient to write in a diary

What is the priority nursing diagnosis for a hyperactive client who is manic during the acute phase?

Risk for injury

The nurse assesses laboratory results for an adult client who takes lithium 600 mg twice a day. The client has been on this regimen for 3 years. Which laboratory value should alert the nurse to confer promptly with the health care provider?

Serum creatinine 1.95 mg/dL

Which statement is true of the relationship between bipolar disorder and suicide?

Suicide is a serious risk, because nearly 20% of those diagnosed with bipolar disorder commit suicide.

A nurse is planning a diet chart for a client who is manic and receiving lithium therapy. Which instruction should the nurse include on the diet chart?

Take lithium with meals.

To plan care for a client who is manic, the nurse must consider that lithium cannot be started until what takes place?

The physical examination and laboratory tests are analyzed.

When the spouse of a client who is manic asks about genetic transmission of bipolar disorder, what knowledge informs the nurse's answer?

The rate of bipolar disorder is higher in first-degree relatives of people with bipolar disorder.

A client who is treated with lithium carbonate shows no improvement and often gets agitated and depressed. Which drug would the nurse expect the primary health care provider to prescribe to the client?

Valproate