Which initial nursing intervention should be planned for a newly ...

[lilldybug07]

Which initial nursing intervention should be planned for a newly admitted patient with acute mania?
 
  a. Allow the patient to act out suppressed feelings because the environment is safe.
  b. Provide verbal instructions to the patient to remain calm and cooperative.
  c. Be accessible to set limits on the patient's behavior as necessary.
  d. Restrain the patient to reduce hyperactivity and aggression.

Question 2

Which characteristics of the unit milieu are most likely to result in a low incidence of violent behavior?
 
  a. A milieu that emphasizes maintaining control and structure
  b. A unit that is adequately staffed and not overcrowded
  c. A unit that has a high percentage of newer, fresher staff
  d. A milieu that focuses on privileges to reward or punish behavior

[Pamela.irrgang@yahoo.com]

Answer to Question 1

C
This intervention provides support through the nurse's presence and provides structure as necessary while the patient's control is tenuous. Acting out may lead to loss of behavioral control. Patient will probably be unable to focus on instruction and comply. Seclusion or restraints are used only after other interventions have proved ineffective.

Answer to Question 2

B
Overcrowding and inadequate staffing are the factors associated with greater numbers of violent episodes. Structure is desirable so long as it is accompanied by a degree of flexibility rather than emphasizing control. Units with higher numbers of new staff tend to have more incidents, owing to limited experience and self-awareness. Privileges can help motivate behavior, but interventions emphasizing punishment are not likely to be therapeutic and more likely to create conflict and evoke hostile responses.