A patient demonstrating characteristics of acute mania relapsed ...

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A patient demonstrating characteristics of acute mania relapsed after discontinuing lithium. New orders are written to resume lithium twice daily and begin olanzapine (Zyprexa).
 
  What is the rationale for the addition of olanzapine to the medication regimen? It will:
 
  a. minimize the side effects of lithium.
  b. bring hyperactivity under rapid control.
  c. enhance the antimanic actions of lithium.
  d. be used for long-term control of hyperactivity.

Question 2

This nursing diagnosis applies to a patient with acute mania: Imbalanced nutrition: less than body requirements related to insufficient caloric intake and hyperactivity as evidenced by 5-pound weight loss in 4 days. Select an appropriate outcome.
 
  The patient will:
 
  a. ask staff for assistance with feeding within 4 days.
  b. drink six servings of a high-calorie, high-protein drink each day.
  c. consistently sit with others for at least 30 minutes at meal time within 1 week.
  d. consistently wear appropriate attire for age and sex within 1 week while on the psychiatric unit.

[makaylafy]

Answer to Question 1

ANS: B
Manic symptoms are controlled by lithium only after a therapeutic serum level is attained. Because this takes several days to accomplish, a drug with rapid onset is necessary to reduce the hyperactivity initially. Antipsychotic drugs neither enhance lithium's antimanic activity nor minimize the side effects. Lithium will be used for long-term control.

Answer to Question 2

ANS: B
High-calorie, high-protein food supplements will provide the additional calories needed to offset the patient's extreme hyperactivity. Sitting with others or asking for assistance does not mean the patient ate or drank. The other indicator is unrelated to the nursing diagnosis.