The nurse is assessing a newly admitted client with a diagnosis ...

[AEWBW]

The nurse is assessing a newly admitted client with a diagnosis of bipolar disorder I. Which of the following questions is appropriately worded?
 
  a. How much sex have you had recently?
  b. Do you have delusions?
  c. Do you feel exhausted?
  d. Have you spent more money than usual recently?

Question 2

Which set of instructions is most appropriate when preparing the patient for collection of a 24-hour creatinine clearance for a prelithium workup?
 
  a. Collect all urine when you wake up and for 12 hours thereafter, and then discard all collected urine, noting the time. Begin again to collect all urine, and refrigerate it for the next 12 hours after your blood is drawn..
  b. Discard your first morning urine on awakening, and then begin to time and collect your urine. Keep it refrigerated in a clean 3-L plastic container. Your blood may be drawn at any time during the collection..
  c. Sign this consent form; then collect your urine for the next 24 hours after discarding the first urine of the morning and then refrigerate the clean 3-L container between voidings..
  d. Sign this consent form, and then begin to collect your urine in a clean 3-L plastic container for 24 hours. You may refrigerate the urine collection if you wish..

[Cnarkel]

Answer to Question 1

C
The most appropriate question for the nurse to ask would focus on whether the client feels exhausted. Assessment for a newly hospitalized client should include the current status of the client. Determining if the client is exhausted provides the nurse with information on whether the client's basic needs have been met. Clients with a diagnosis of bipolar disorder I may experience symptoms of depression such as little appetite or difficulties with getting adequate, restful sleep. A client with mania would be exhausted because of his or her constant activity, which would interfere with taking the time to eat or sleep.

Answer to Question 2

B
No consent form is required for this 24-hour urine and serum collection. Blood may be drawn at any time during the collection. In the morning the first voiding is discarded, and then the collection is timed and urine is collected for 24 hours. All urine is stored in a clean, 3-L plastic container that is refrigerated when not in use and then delivered to the lab. Teaching the patient the procedure for a 24-hour creatinine clearance as part of a prelithium workup (urinalysis, BUN, TSH, T3 and T4, FBS, and a complete physical examination with history and workup for family history of renal disease, diabetes mellitus, hypertension, diuretic use, and analgesic abuse) is required.

[AEWBW]

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