A patient with bipolar disorder was hospitalized 7 days earlier ...

[ssal]

A patient with bipolar disorder was hospitalized 7 days earlier and has been taking lithium 600 mg three times daily. Staff members observe increased agitation, pressured speech, poor personal hygiene, hyperactivity, and bizarre clothing.
 
  What is the nurse's best intervention?
 
  a. Educate the patient about the proper ways to perform personal hygiene and coordinate clothing.
  b. Continue to monitor and document the patient's speech patterns and motor activity.
  c. Ask the health care provider to prescribe an increased dose and frequency of lithium.
  d. Consider the need to check the lithium level. The patient may not be swallowing medications.

Question 2

A patient with mania dances around the unit, seldom sits, monopolizes conversations, interrupts, and intrudes. Which nursing intervention will best assist the patient with energy conservation?
 
  a. Monitor physiologic functioning.
  b. Provide a subdued environment.
  c. Supervise personal hygiene.
  d. Observe for mood changes.

[Kedrick2014]

Answer to Question 1

ANS: D
The patient is continuing to exhibit manic symptoms. The lithium level may be low as a result of cheeking the medication. The prescribed dose is high, so one would not expect a need for the dose to be increased.

Answer to Question 2

ANS: B
All the options are reasonable interventions with a patient with acute mania, but providing a subdued environment directly relates to the outcome of energy conservation by decreasing stimulation and helping balance activity and rest.

[ssal]

Gracias!

[Chelseyj.hasty]

Excellent