A client with bipolar disorder has not slept or eaten in four days. The client is pacing and becomes increasingly agitated and loud while the nurse talks to the client's spouse. Which intervention is best for the nurse to implement at this time?

A) While it is important for the family to communicate love and concern, this goal does not directly address the immediate medical needs of the adolescent. Focusing on emotional support is valuable, but it is secondary to the need for nutritional recovery.

B) The goal for the client to eat nutritious meals in the hospital cafeteria has the highest priority. Ensuring adequate nutrition is critical in the treatment of anorexia nervosa, as the client is at risk for severe physical complications due to malnutrition. This goal directly addresses the client’s immediate health needs and forms the foundation for further psychological recovery.

C) Verbalizing feelings of positive self-esteem is an important long-term goal in the treatment of anorexia nervosa; however, it cannot be effectively achieved without first addressing the client’s nutritional and physical health needs. Self-esteem often improves with physical recovery, so it should be a goal to work toward after establishing a solid nutritional foundation.

D) While regular family therapy sessions can be beneficial for the overall treatment plan, this goal does not take precedence over the need for the client to stabilize their physical health. Family involvement is important, but the immediate priority should be on the client's individual recovery and nutritional needs.

A) Performing the dressing change in a non-judgmental manner is crucial when caring for a client with borderline personality disorder. Clients with this diagnosis often have intense emotions and may feel vulnerable, so approaching the situation without judgment fosters a sense of safety and respect. This supportive attitude can help build trust and encourage open communication.

B) While providing thorough explanations when cleansing the wound can be beneficial, excessive detail may overwhelm the client or create anxiety. It is important to communicate effectively, but the focus should be on providing care in a compassionate manner rather than on the specifics of the procedure, especially given the client’s emotional state.

C) Asking the client in a non-threatening manner why they cut their abdomen could be perceived as intrusive or confrontational, potentially leading to defensiveness or escalation of emotions. This approach may not be appropriate during a dressing change; instead, it may be more effective to address the reasons for self-harm in a separate therapeutic context when the client is more stable.

D) Requesting another staff member to assist with the dressing change might be necessary in certain situations, but it could also convey a sense of fear or discomfort regarding the client’s behavior. In this case, it is essential for the nurse to manage the situation confidently and compassionately, rather than distancing themselves from the client’s needs. Fostering a supportive environment is more important than involving additional staff at this moment.