Mental Health Chapter 13

The spouse of a client 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 clients with bipolar disorder."

A client experiencing acute mania undresses in the group room and dances. How should the nurse intervene initially?

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

A client 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 client's behavior?

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

A client 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 client demonstrating characteristics of acute mania relapsed after discontinuing lithium. New orders are written to resume lithium twice daily and begin olanzapine. What is the rationale for the addition of olanzapine to the medication regimen?

To bring hyperactivity under rapid control.

A health teaching plan for a client taking lithium should include which instructions?

maintain normal salt and fluids in the diet.

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

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

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

Provide a subdued environment.

A client 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 client diagnosed with acute mania is hospitalized, what is the initial nursing intervention?

Set limits on client behavior as necessary.

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

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

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

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

. A client newly diagnosed with bipolar disorder is prescribed lithium. Which information from the client's medical history indicates that monitoring of serum concentrations of the drug will be challenging and critical?

Heart failure

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

Attending psychoeducation sessions

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

Diaphoresis, weakness, and nausea

Which nursing diagnosis would most likely apply to a client diagnosed with major depressive disorder as well as one experiencing acute mania?

Disturbed sleep pattern

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

Euphoric

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 client's plan of care?

Hyperactivity; not eating and sleeping

At a unit meeting, the staff discusses decor for a special room for clients 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

Four new clients were admitted to the behavioral health unit in the past 12 hours. The nurse directs a psychiatric technician to monitor these clients for safety. Which client diagnosis will need the most watchful supervision?

bipolar I disorder.

A client 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

Outcome identification for the treatment plan of a client experiencing grandiose thinking associated with acute mania will focus on what?

distorted thought self-control.

A client diagnosed with bipolar disorder who takes lithium carbonate 300 mg three times daily reports nausea. To reduce the nausea most effectively, the nurse suggests that the lithium be taken with what?

food.

A client 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." What is the nurse's appropriate intervention?

inviting the client to sit together and look at new fashion magazines.

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

lamotrigine

While the exact cause of bipolar disorder has not been determined; however, what is consistent for most clients?

several factors, including genetics, are implicated.

The nurse receives a laboratory report indicating a client's serum level is 1 mEq/L. The client's last dose of lithium was 8 hours ago. What does this result indicate?

within therapeutic limits.