A newly admitted patient is experiencing a manic episode. The patient is verbally and physically aggressive. The plan for care should include
a. setting clear limits, providing a quiet environment, and limiting activities.
b. avoiding use of antipsychotic drugs for 24 hours and providing nourishment ad lib.
c. orienting to unit activities, encouraging gross motor activity, and watching television.
d. avoiding confrontations by not enforcing limits and encouraging physical exercise at bedtime.
A
Stimuli should be reduced to provide a simple, quiet, and nonstimulating environment. Clear limits should be explained in as few words as possible, and then maintained. Gross motor activity should be limited to prevent exhaustion, and exercise should not be encouraged at bedtime. Quiet activity is more conducive to initiating sleep. Intake should be monitored and food and fluids encouraged to compensate for the higher energy expenditure of the patient. Antipsychotic drugs will probably be needed to reduce activity and aggressiveness.
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