A 42-year-old client with bipolar disorder has been hospitalized on the inpatient psychiatric unit. She is dancing around, talking incessantly, and singing. Much of the time the client is anorexic and eats very little from her tray before she is up and about again.

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A 42-year-old client with bipolar disorder has been hospitalized on the inpatient psychiatric unit. She is dancing around, talking incessantly, and singing. Much of the time the client is anorexic and eats very little from her tray before she is up and about again.

The nurse’s intervention would be to:
A . Confront the client with the fact that she will have to eat more from her tray to sustain her
B . Try to get the client to focus on her eating by offering a detailed discussion on the importance of nutrition
C . Let her have snacks and drinks anytime that she wants them because she will not eat at regular meal times
D . Not expect the client to sit down for complete meals; monitor intake, offering snacks and juice frequently

Answer: D

Explanation:

(A) The manic client’s mood may easily change from euphoric to irritable. The nurse should avoid confrontation and let the client know what she can do, rather than what she cannot.

(B) Although helpful to refocus or redirect the manic client to discuss only one topic at a time, distractibility is very high and it’s best to avoid long discussions.

(C) Manic clients have a tendency to manipulate persons in their environment. Staff should monitor intake, including at mealtime and snacks, and be consistent in their approach to meeting nutritional needs.

(D) Manic clients may not sit and eat complete meals, but they can carry foods and liquids from regular meals with them. Staff can monitor and give high-caloric and high-energy snacks and liquids.

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