Therapeutic interactions between the nurse and a manic client ...

[humphriesbr@me.com]

Therapeutic interactions between the nurse and a manic client will be facilitated when the nurse:
 
  1. Uses a calm, matter-of-fact approach to structuring
  2. Focuses primarily on enforcing rigid limits
  3. Implements a laissez-faire approach to client behavior
  4. Encourages client use of humor and wit

Question 2

A client who is experiencing a manic episode approaches the nurse and with pressured speech states, I hate oatmeal. Let's get everybody together to do exercises. I'm thirsty and I'm burning up.
 
  Get out of my way, I have to see that guy. The priority nursing action should be to:
  1. Measure the client's temperature and pulse
  2. Offer to have the dietitian visit to discuss his diet
  3. Tell the client he can lead exercises at community meeting
  4. Sigh with relief when the client ends the interaction and walks away

[Ptupou85]

Answer to Question 1

ANS: 1
A calm, matter-of-fact approach minimizes client need for defensiveness and minimizes power struggles. 2. The use of rigid limit setting leads to power struggles and escalation of client hyper-active, aggressive behavior. Structure and judicious limit setting are more therapeutic. 3. A lais-sez-faire approach is nontherapeutic; manic clients usually need structure. 4. Encouraging humor and wit often backfires. Clients with mania cannot maintain control of emotions and may shift from witty to angry in seconds.

Answer to Question 2

ANS: 1
During a manic episode, the client may be inattentive to physical needs or illness. The brief re-mark about burning up could suggest fever. Thirst may accompany fever, be a sign of dehydra-tion, or be related to lithium administration. More information is needed. Because hyperactive clients have difficulty remaining still, taking the temperature and pulse will give priority infor-mation. If necessary, BP can be taken later. Option 2 is not a priority intervention. Option 3 fos-ters increased hyperactivity. Option 4 would not be therapeutic.

[humphriesbr@me.com]

Gracias!

[abro1885]

TYSM