A client with bipolar disorder resides in a group home and ...

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A client with bipolar disorder resides in a group home and frequently violates the boundaries of other residents and exhibits aggression. How should the nurse who works at this facility best respond to this resident's actions?
 
  A) Administer benzodiazepines frequently to increase serum levels prior to a manic episode
  B) Ensure that the client knows that there will be punitive measures if the client exhibits inappropriate behavior
  C) Gradually increase the client's lithium dosages in anticipation of a manic episode
  D) Develop a behavioral care plan in collaboration with the client to foster self-control

Question 2

A 35-year-old man with bipolar disorder has a history of discontinuing his medication when he feels well and then becomes manic again.
 
  During his last episode of mania, he lost several thousand dollars in risky investments. Which intervention will be most helpful in achieving medication adherence?
  A) Point out that each time he stops taking medication he becomes manic again
  B) Discuss signs, symptoms, and consequences of relapse
  C) Ensure that a family member takes responsibility for administering medications
  D) Remind him that he owes it to his wife and children to stay well

[nyrave]

Answer to Question 1

Ans: D
Feedback:
Developing a behavioral care plan with input from clients helps maintain self-control. Similar to a contract, a behavioral care plan details parameters for social interaction, such as which behaviors and comments are (or are not) appropriate. Benzodiazepines are not normally used on a prophylactic basis and it would be inappropriate to unilaterally increase a client's lithium dosages. Punishment is not used as a behavior modification technique.

Answer to Question 2

Ans: B
Feedback:
To help link the importance of taking medication with relapse prevention, the nurse lists target symptoms and identifies signs of imminent relapse. He or she problem-solves with the client about early management of symptoms so severity does not increase.

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TYSM

[bulacsom]

Thanks for the timely response, appreciate it