A nurse is planning care for a client who is in the manic phase of bipolar disorder.

Which of the following interventions should the nurse include in the client's plan of care?.

Choice A rationale:

Mental separation from distractions during painting is a healthy coping mechanism, allowing for focus and mindfulness.

It falls under the adaptive defense mechanism of compartmentalization, which involves temporarily separating thoughts and emotions to manage stress effectively.

It doesn't deny or distort reality, but rather creates a temporary mental space for relaxation and creativity.

Choice B rationale:

Writing a short story about a heroic woman is a form of sublimation, channeling negative emotions into a productive and creative outlet.

It's a mature defense mechanism that allows for indirect expression of anger or frustration without causing harm to oneself or others.

It can lead to personal growth and insight, as it encourages reflection and exploration of emotions through storytelling.

Choice C rationale:

Inability to recall the scene of a traumatic event is likely a dissociative defense mechanism, protecting the individual from overwhelming psychological distress.

It's a common response to trauma, and while it may be maladaptive in the long term if it prevents processing the trauma, it serves a protective function in the acute phase.

It doesn't necessarily indicate a maladaptive coping style overall, but rather a specific response to a traumatic experience.

Choice D rationale:

Declaring disinterest in work after being denied a promotion exemplifies disengagement, a maladaptive coping mechanism involving withdrawal and apathy.

It reflects an inability to cope with disappointment or setbacks in a constructive way.

It can lead to social isolation, decreased motivation, and potentially depression or other mental health issues.

A rationale:

Spending time with friends can be a protective factor against suicide, as it provides social support and connection.

While isolation can be a risk factor, spending time with friends does not inherently indicate suicide risk.

It's important to assess the quality of relationships and the presence of other risk factors.

Choice B rationale:

Regular sleep patterns often indicate healthy mental health.

Significant changes in sleep patterns (either too much or too little) can be warning signs, but consistent sleep of 9 hours is not typically a concern.

It's essential to evaluate sleep quality and any recent changes.

Choice C rationale:

Religious involvement can provide a sense of purpose, belonging, and support, which can be protective against suicide.

While it's not a guarantee of protection, it's generally a positive factor.

It's crucial to assess the individual's level of engagement and any potential conflicts within their religious beliefs.

Choice D rationale:

Exposure to suicide, especially in a close connection like a coach, can significantly increase a person's risk for suicide.

It can lead to normalization of suicide as a coping mechanism, imitation of behavior, or triggering of underlying mental health issues.

This is a strong risk factor that warrants immediate attention and assessment.