A nurse is planning care for a client who is in the manic phase of bipolar disorder. Which of the following goals should the nurse include?

Client sleeps 6 hr each night.

Client has a 0.9 kg (2 lb) weight loss from previous week.

Client has an increase in urine specific gravity

Client gives personal gifts to other clients.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

During the manic phase of bipolar disorder, sleep disturbances are common. Setting a goal for the client to achieve an appropriate amount of sleep can help stabilize their mood and reduce the intensity of manic symptoms.

Choice B rationale:

A weight loss goal might be more appropriate during the depressive phase, as manic episodes are often associated with increased energy and decreased appetite.

Choice C rationale:

Increased urine specific gravity is not a specific goal for managing the manic phase of bipolar disorder.

Choice D rationale:

Giving personal gifts to other clients might be a manifestation of the client's manic behavior and is not a goal to strive for.

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Correct Answer is C

Explanation

Choice A rationale:

Developing influenza after receiving the vaccine the previous year is not a contraindication for receiving the vaccine this year. In fact, the vaccine is recommended annually.

Choice B rationale:

Hypertension is not a contraindication for receiving the influenza vaccine.

Choice C rationale:

Clients with a history of Guillain-Barré syndrome should generally avoid receiving the influenza vaccine due to a potential increased risk of recurrence of the syndrome.

Choice D rationale:

Allergies to dairy products are not a contraindication for receiving the influenza vaccine.

A. "Restrict your fluid intake while taking lithium. B. "Double your dose of lithium if you experience blurred vision." C. "Consume a moderate-sodium diet while taking lithium." D. "Slurred speech can indicate that your lithium level is low."

Correct Answer is C

Explanation

Choice A rationale:

Restricting fluid intake is not the primary concern when taking lithium. It's more important to maintain a consistent level of sodium intake.

Choice B rationale:

Doubling the dose of lithium without medical supervision can lead to lithium toxicity, which can be life-threatening.

Choice C rationale:

Sodium levels can impact the effectiveness and safety of lithium. Consuming a moderate- sodium diet helps prevent sodium depletion or overload, which can affect lithium levels.

Choice D rationale:

Slurred speech is not indicative of low lithium levels. It's important to monitor for signs of lithium toxicity, which include tremors, confusion, and GI symptoms.

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A nurse is planning care for a client who is in the manic phase of bipolar disorder. Which of the following goals should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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