A patient diagnosed with bipolar disorder commands other patients, "Get me a book. Take this stuff out of here," and other similar demands. The nurse wants to interrupt this behavior without entering into a power struggle
Which initial approach should the nurse select?
a. Distraction: "Let's go to the dining room for a snack."
b. Humor: "How much are you paying servants these days?"
c. Limit setting: "You must stop ordering other patients around."
d. Honest feedback: "Your controlling behavior is annoying others."
ANS: A
The distractibility characteristic of manic episodes can assist the nurse to direct the patient toward more appropriate, constructive activities without entering into power struggles. Humor usually backfires by either encouraging the patient or inciting anger. Limit setting and honest feedback may seem heavy-handed and may incite anger.
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