Author Question: A patient diagnosed with bipolar disorder commands other patients, Get me a book. Take this stuff ... (Read 19 times)

storky111 · **on:** Jul 19, 2018

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?

a. Distraction: Let's go to the dining room for a snack.
b. Humor: How much are you paying servants these days?
c. Limit setting: You must stop ordering other patients around.
d. Honest feedback: Your controlling behavior is annoying others.

Question 2

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?

a. phenytoin (Dilantin)
b. clonidine (Catapres)
c. risperidone (Risperdal)
d. carbamazepine (Tegretol)

Shshxj · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

ANS: A
The distractibility characteristic of manic episodes can assist the nurse to direct the patient toward more appropriate, constructive activities without entering into power struggles. Humor usually backfires by either encouraging the patient or inciting anger. Limit setting and honest feedback may seem heavy-handed and may incite anger.

Answer to Question 2

ANS: D
Some patients with bipolar disorder, especially those who have only short periods between episodes, have a favorable response to the anticonvulsants carbamazepine and valproate. Carbamazepine seems to work better in patients with rapid cycling and in severely paranoid, angry manic patients. Phenytoin is also an anticonvulsant but not used for mood stabilization. Risperidone is not an anticonvulsant. See relationship to audience response question.