A nurse is collecting data from a 24-month-old toddler during an annual physical examination.
Which of the following findings should the nurse report to the provider?

Collaborate with the client to develop a daily physical exercise routine. This intervention can help reduce aggression and impulsivity in schizophrenia by providing an outlet for frustration, enhancing self-esteem, and improving mood. Physical exercise can also improve physical health and reduce the risk of metabolic syndrome associated with antipsychotic medications.

Choice A is wrong because warning the client that the staff will use seclusion as a consequence if there are repeated reports of hallucination is punitive and threatening. This can increase the client’s anxiety, paranoia, and hostility, and may worsen the psychotic symptoms. Seclusion should only be used as a last resort when the client poses a serious danger to self or others, and not as a punishment or coercion.

Choice B is wrong because keeping the facility’s security personnel constantly visible to the client throughout treatment is intimidating and stigmatizing. This can also increase the client’s fear, distrust, and resentment, and may trigger aggressive behavior. Security personnel should only be involved when there is an imminent risk of violence, and not as a routine measure.

Choice D is wrong because agreeing that the hallucinations are real if the client exhibits aggressive behavior toward other clients is reinforcing the delusional belief and rewarding the aggression. This can also confuse the client and undermine the therapeutic relationship.

The nurse should acknowledge the client’s experience of hallucinations, but not endorse them as reality. The nurse should also set clear limits on aggressive behavior and use de-escalation techniques to calm the client.

The nurse should offer the client a milkshake because it is a high-calorie, high- protein, and easy-to-consume food that can meet the nutritional needs of a client who is in the manic phase of bipolar disorder. Clients who are manic often have increased activity, decreased appetite, and poor attention span, which can lead to weight loss and malnutrition.

Choice A is wrong because Creamed corn is wrong because it is a low-protein, high-carbohydrate food that can increase blood glucose levels and cause mood swings.

Choice B is wrong because Mashed potatoes is wrong because it is a low-protein, high-starch food that can also affect blood glucose levels and mood stability.

Choice C is wrong because Spaghetti with meat sauce is wrong because it is a complex food that requires utensils and attention to eat, which can be difficult for a client who is manic and distractible.

Normal ranges for potassium are 3.5 to 5.0 mEq/L.