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People with mania are hyperactive and often do not take time to eat and drink properly. Their high levels of activity consume calories, so deficits in nutrition may occur. The mood evidences euphoria and is labile. Sleep is reduced. Their socialization is impaired but not isolated. Confusion may be acute but not chronic.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Pages 13-18, 44 (Table 13-2)

MSC: Client Needs: Psychosocial Integrity

TOP: Nursing Process: Diagnosis/Analysis a. Powerlessness b. Defensive coping c. Chronic low self-esteem d. Impaired social interaction e. Risk-prone health behavior

3. A patient tells the nurse, “I’m ashamed of being bipolar. When I’m manic, my behavior embarrasses everyone. Even if I take my medication, there are no guarantees. I’m a burden to my family.” These statements support which nursing diagnoses? (Select all that apply.)

ANS: A, C

Chronic low self-esteem and powerlessness are interwoven in the patient’s statements. No data support the other diagnoses.

PTS: 1 DIF: Cognitive Level: Analyze (Analysis)

REF: Pages 13-13, 14, 18, 33, 44 (Table 13-2)

TOP: Nursing Process: Diagnosis/Analysis

MSC: Client Needs: Psychosocial Integrity a. Touch the patient to provide reassurance. b. Invite the patient to lead a community meeting. c. Provide a structured environment for the patient. d. Ensure that the patient’s nutritional needs are met. e. Design activities that require the patient’s concentration.

4. The plan of care for a patient in the manic state of bipolar disorder should include which interventions? (Select all that apply.)

ANS: C, D

People with mania are hyperactive, grandiose, and distractible. It is most important to ensure the patient receives adequate nutrition. Structure will support a safe environment. Touching the patient may precipitate aggressive behavior. Leading a community meeting would be appropriate when the patient’s behavior is less grandiose. Activities that require concentration will produce frustration.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Pages 13-18, 19 (Case Study and Nursing Care Plan), 46 (Table 13-3)

TOP: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity