A patient 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
Select the best initial approach by the nurse.
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 a power struggle. Humor usually backfires by either encouraging the patient or inciting anger. Limit setting and honest feedback may seem heavy-handed to a labile patient and may incite anger.
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