A patient displaying symptoms of mania has spent the entire morning pacing in the dayroom and now has begun verbally intimidating other patients. The nurse manages the milieu by:
a. obtaining a telephone order to seclude the patient.
b. stating, "You can't frighten the other patients.".
c. escorting the patient out of the dayroom.
d. distracting the patient with the television.
C
A less stimulating environment would be therapeutic for the patient but seclusion would not be the initial intervention. Verbal interventions would not be successful in providing the necessary structure; another approach to limit setting should be tried. When sufficient staff members are assembled, one nurse should set limits by saying, "We are here to walk to your room with you.". The presence of other staff members ensures that the limit setting can be safely implemented. The patient's active state would not be distracted by the television.
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