A bipolar client with acute mania has been verbally abusive to ...

[sammy]

A bipolar client with acute mania has been verbally abusive to staff since admission 3 hours ago.
 
  He
  tells the admitting nurse she'd probably make a better call girl than a nurse and refuses to answer
  assessment questions, saying If you can't work with patients they'll eventually fire you.. The nurse
  should
  a. explain to the client that she holds a degree in nursing and is entirely competent.
  b. tell the client his behavior is unacceptable and requires an apology.
  c. state she will return in a few minutes to continue the interview.
  d. tell the client she will report his behavior to the physician.

Question 2

A bipolar client being maintained on lithium calls the nurse at the clinic to say he has had severe
  diarrhea for 4 days. He mentions that he feels very weak and kind of staggers when he walks.
 
  He
  states his usual hand tremor has gotten worse. The nurse should advise
  a. having someone bring the client to the clinic immediately.
  b. restricting food and fluids for 24 hours and staying in bed.
  c. drinking a large glass of water with 1 teaspoon of salt added.
  d. taking over-the-counter antidiarrheal medication hourly until the diarrhea
  subsides.

[zhanghao]

Answer to Question 1

C
Angry verbal attacks against staff by clients with mania are commonplace. Staff must realize verbal
attacks are part of illness behavior rather than personal in nature. Arguing, explaining, calling for
apologies are counterproductive behaviors. Remaining neutral and allowing a cooling-down period
will serve the nurse well. Because the client's mood is labile, the client may be willing to continue
the assessment when the nurse returns.

Answer to Question 2

A
The symptoms described suggest lithium toxicity. The client should have a lithium level drawn and
may require further treatment. Because neurological symptoms are present, the client should not
drive and should be accompanied by another person. Options B, C, and D: These will not ameliorate
the client's symptoms.

[sammy]

Excellent

[sultana.d]

TYSM