A nurse is assisting with the plan of care for a client who is in the manic phase of bipolar disorder.
Which of the following interventions should the nurse recommend to include?

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.

1. Answer and explanation The correct answers are:

Condition:

1. Mania Actions:
2. Daily weight

D. Suicidal behavior

Parameters to monitor:

Blood pressure and pulse rate

Food intake during meals

Rationale for condition:

Choice A: Mania

The client's presentation is consistent with the manic phase of bipolar disorder.

Key features of mania include:

Elevated mood or irritability

Increased energy and activity levels

Racing thoughts and rapid speech

Decreased need for sleep Impulsive behavior

Distractibility

Poor judgment

Grandiosity

Auditory hallucinations Rationale for actions:

Choice B: Daily weight

Weight loss is a common symptom of mania due to increased activity levels and decreased appetite.

Monitoring weight helps assess the severity of mania and the need for nutritional interventions.

Choice D: Suicidal behavior

Individuals with bipolar disorder are at increased risk for suicide, especially during manic episodes.

Close monitoring for suicidal ideation and behavior is crucial for safety.

Rationale for parameters to monitor:

Choice A: Blood pressure and pulse rate

Mania can lead to physiological changes such as increased heart rate and blood pressure.

Monitoring these vital signs helps assess the physical impact of mania and the potential need for medical interventions.

Choice C: Food intake during meals

As mentioned, decreased appetite is common in mania.

Monitoring food intake ensures adequate nutrition and prevents dehydration.