During the evening shift on an inpatient psychiatric unit, a practical nurse (PN) observes a client diagnosed with bipolar disorder pacing forcefully around the dayroom. The client is speaking loudly, invading the personal space of others, and aggressively demanding that the television channel be changed. How should the PN initially intervene?
- Approach the client with a calm demeanor, maintain a safe physical distance, and offer to walk together to the dining area for a snackAnswer
- BInstruct the client to sit down and logically explain how their current behavior is frightening the other individuals in the room
- CImmediately guide the client into a seclusion room to ensure the physical safety of the peers in the dayroom
- DAsk the client why the current television program is making them so angry that they feel the need to shout
Answer
The correct response is to approach the client calmly, respect their personal space, and use distraction by offering to walk to a different area for a snack.
For a client in a manic phase of bipolar disorder exhibiting escalating agitation, the priority is to maintain safety while using the least restrictive intervention. A calm approach, maintaining physical distance, and utilizing distraction (such as offering a snack and suggesting a walk) effectively removes the client from the stimulating dayroom environment without provoking a power struggle or requiring physical restraint.
Step-by-Step Solution
Key Concept
Crisis De-escalation and Least Restrictive Interventions