BH Exam 4 ch 13

The spouse of a patient diagnosed with bipolar disorder asks what evidence supports the possibility of genetic transmission of bipolar disorders. Which response should the nurse provide?

A higher rate of relatives with bipolar disorder is found among patients with bipolar disorder.

An outpatient diagnosed with bipolar disorder takes lithium carbonate 300 mg three times daily. The patient reports nausea. To reduce the nausea most effectively, the nurse suggests that the lithium be taken with:

meals.

A patient experiencing acute mania undresses in the group room and dances. The nurse intervenes initially by:

putting a blanket around the patient and walking with the patient to a quiet room.

A patient demonstrating behaviors associated with acute mania has exhausted the staff by noon. Staff members are feeling defensive and fatigued. Which action will the staff take initially?

Hold a staff meeting to discuss consistency and limit-setting approaches.

A patient diagnosed with bipolar disorder is in the maintenance phase of treatment. The patient asks, Do I have to keep taking this lithium even though my mood is stable now? Select the nurses appropriate response.

Taking the medication every day helps reduce the risk of a relapse.

Outcome identification for the treatment plan of a patient experiencing grandiose thinking associated with acute mania will focus on:

distorted thought self-control.

A health teaching plan for a patient taking lithium should include instructions to:

maintain normal salt and fluids in the diet.

Which dinner menu is best suited for a patient with acute mania?

Broiled chicken breast on a roll, an ear of corn, and an apple

A patient experiencing acute mania dances around the unit, seldom sits, monopolizes conversations, interrupts, and intrudes. Which nursing intervention will best assist the patient with energy conservation?

Provide a subdued environment.

A patient diagnosed with acute mania has distributed pamphlets about a new business venture on a street corner for 2 days. Which nursing diagnosis has priority?

Risk for injury

When a hyperactive patient diagnosed with acute mania is hospitalized, what is the initial nursing intervention?

Set limits on patient behavior as necessary.

A patient diagnosed with bipolar disorder will be discharged tomorrow. The patient is taking a mood stabilizing medication. What is the priority nursing intervention for the patient as well as the patients family during this phase of treatment?

Attending psychoeducation sessions

A patient diagnosed with bipolar disorder is dressed in a red leotard and bright scarves. The patient twirls and shadow boxes. The patient says gaily, Do you like my scarves? Here; they are my gift to you. How should the nurse document the patients mood?

Euphoric

A newly diagnosed patient is prescribed lithium. Which information from the patients history indicates that monitoring of serum concentrations of the drug will be challenging and critical?

Heart failure

A patient with diagnosed bipolar disorder was hospitalized 7 days ago and has been taking lithium 600 mg tid. Staff observes increased agitation, pressured speech, poor personal hygiene, and hyperactivity. Which action demonstrates that the nurse understands the most likely cause of the patients behavior?

Consider the need to check the lithium level. The patient may not be swallowing medications.

Which documentation indicates that the treatment plan for a patient diagnosed with acute mania has been effective?

Converses with few interruptions; clothing matches; participates in activities.

A nurse assesses a patient who takes lithium. Which findings demonstrate evidence of complications?

Diaphoresis, weakness, and nausea

A patient diagnosed with bipolar disorder commands other patients, Get me a book. Take this stuff out of here, and other similar demands. The nurse wants to interrupt this behavior without entering into a power struggle. Which initial approach should the nurse select?

Distraction: Lets go to the dining room for a snack.

Which nursing diagnosis would most likely apply to both a patient diagnosed with major depression as well as one experiencing acute mania?

Disturbed sleep pattern

A patient diagnosed with bipolar disorder becomes hyperactive after discontinuing lithium. The patient threatens to hit another patient. Which comment by the nurse is appropriate?

Do not hit anyone. If you are unable to control yourself, we will help you.

A person was directing traffic on a busy street, rapidly shouting, To work, you jerk, for perks and making obscene gestures at cars. The person has not slept or eaten for 3 days. Which assessment findings will have priority concern for this patients plan of care?

Hyperactivity; not eating and sleeping

At a unit meeting, the staff discusses decor for a special room for patients with acute mania. Which suggestion is appropriate?

Neutral walls with pale, simple accessories

A person was online continuously for over 24 hours, posting rhymes on official government websites and inviting politicians to join social networks. The person has not slept or eaten for 3 days. What features of mania are evident?

Poor judgment and hyperactivity

A patient with acute mania has disrobed in the hall three times in 2 hours. The nurse should:

arrange for one-on-one supervision.

Four new patients were admitted to the behavioral health unit in the past 12 hours. The nurse directs a psychiatric technician to monitor these patients for safety. Which patient will need the most watchful supervision? A patient diagnosed with:

bipolar I disorder.

A patient demonstrating characteristics of acute mania relapsed after discontinuing lithium. New orders are written to resume lithium twice daily and begin olanzapine (Zyprexa). What is the rationale for the addition of olanzapine to the medication regimen? It will:

bring hyperactivity under rapid control.

A patient diagnosed with bipolar disorder has rapidly changing mood cycles. The health care provider prescribes an anticonvulsant medication. To prepare teaching materials, which drug should the nurse anticipate will be prescribed?

carbamazepine (Tegretol)

A patient experiencing acute mania is dancing atop a pool table in the recreation room. The patient waves a cue in one hand and says, Ill throw the pool balls if anyone comes near me. To best assure safety, the nurses first intervention is to:

clear the room of all other patients.

This nursing diagnosis applies to a patient with acute mania: Imbalanced nutrition: less than body requirements related to insufficient caloric intake and hyperactivity as evidenced by 5-pound weight loss in 4 days.Select an appropriate outcome. The patient will:

drink six servings of a high-calorie, high-protein drink each day.

An outpatient diagnosed with bipolar disorder is prescribed lithium. The patient telephones the nurse to say, Ive had severe diarrhea for 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do? The nurse will advise the patient to:

have someone bring the patient to the clinic immediately

A patient waves a newspaper and says, I must have my credit card and use the computer right now. A store is having a big sale, and I need to order 10 dresses and four pairs of shoes. Select the nurses appropriate intervention. The nurse:

invites the patient to sit together and look at new fashion magazines.

Consider these three anticonvulsant medications: divalproex (Depakote), carbamazepine (Tegretol), and gabapentin (Neurontin). Which medication also belongs to this classification?

lamotrigine (Lamictal)

The exact cause of bipolar disorder has not been determined; however, for most patients:

several factors, including genetics, are implicated.

The nurse receives a laboratory report indicating a patients serum level is 1 mEq/L. The patients last dose of lithium was 8 hours ago. This result is:

within therapeutic limits.