A nurse is assessing a client who is receiving morphine IV for pain. Which of the following findings should the nurse report to the provider first?

• Lack of sleep: Decreased need for sleep is a core feature of mania, where individuals may go days with minimal rest and still appear energetic or overly active. It is not a defining feature of psychosis, though it may occur secondarily.
• Pressured speech: Pressured, rapid, and difficult-to-interrupt speech is strongly associated with mania, reflecting accelerated thought processes and elevated mood. It is uncommon in psychosis unless mania and psychotic features coexist.
• Disorganized thought process: This is a hallmark of psychosis, often seen in disorders like schizophrenia. It includes loose associations, tangentiality, and difficulty organizing ideas, and can impair communication significantly.
• Excessive spending habits: Engaging in impulsive or risky financial behaviors is a classic symptom of mania, often driven by grandiosity or impaired judgment. This behavior is not typical of psychosis unless mania is also present.
• Hallucinations: Perceptual disturbances such as seeing or hearing things that are not present are definitive features of psychosis. While they can occur in severe mania with psychotic features, they are primarily linked to psychotic disorders.

A. Have the client store smaller tanks under his bed. Oxygen tanks should never be stored in enclosed or confined spaces such as under a bed due to the risk of fire and poor ventilation, which can increase the danger of oxygen accumulation.
B. Place the oxygen tank away from curtains or drapes. This is essential to reduce the risk of fire. Oxygen supports combustion, so keeping the tank away from flammable materials like curtains helps ensure a safe home environment.
C. Store the oxygen tank wrench in a locked cabinet. The wrench should be kept accessible, not locked away, to allow quick adjustments or shut-off in case of emergency. Immediate access is a priority in safe oxygen use.
D. Ensure that the client checks the gauge weekly. The oxygen tank gauge should be monitored more frequently than once a week to avoid running out of oxygen unexpectedly, especially in clients with chronic respiratory conditions like COPD.