A 28-year-old elementary school teacher begins to exhibit uncharacteristic behav

Question

A 28-year-old elementary school teacher begins to exhibit uncharacteristic behaviors such as having multiple sexual partners, engaging in compulsive online shopping, barely sleeping, dressing in a more provocative fashion, and attending frequent “wild” parties. Friends and family report these recent behaviors as “totally unlike her,” describing her as a normally conservative, responsible person. Her cousin, who lives nearby, becomes concerned and accompanies the woman to a Crisis Unit where she is subsequently diagnosed with Bipolar Disorder and admitted to a Mental Health Unit. Initial Discussion Post: Address the following: • What is the priority RN action for this client? • Which medical concerns may be significant, considering this client’s recent behavior? • Discuss what the RN would teach the client about Bipolar Disorder. • Provide two nursing diagnosis statements (each statement must include an actual nursing diagnosis (no risk-for diagnoses), related factor and as evidenced by) that might apply to this client.

Explanation / Answer

1. ANS: The RN priority of action:

According to the given situation the RN should first give priority for his client safety. In this situation the client was present in depressive or maniac phase of bipolar disorder and it is usually suicidal condition. So at first the nurse needs to make sure about the client is safe while she is admitted in the hospital.

2. ANS: Medical concerns for client’s recent behavior:

The medical concern would be hyperactivity and poor intake of food. Bipolar patients tend to be overly active and do not eat well. Many days of inadequate sleep, inadequate food and hyperactivity would make them at risk of malnutrition and exhaustion.

3. ANS: RN teaching about Bipolar Disorder:

Bipolar disorder is a chronic mental illness with mood swings varying from depression to mania. There may be times of hyperactive elated mood and there may be times of depression. The client always needs to be in a safe environment. She should be under the follow up care of a psychiatrist. He may prescribe long term mood stabilizers whose levels need to be maintained. Psychotherapy also is provided. The condition may be controlled to some extent with adequate treatment and family support.

4. ANS: Nursing diagnosis statements:

A. Disturbed sleep pattern related to delusion episodes secondary to bipolar disorder as evidenced by the client barely sleeping.

B. Disturbed thought process related to alteration in the mood as evidenced by uncharacteristic behavior such as compulsive shopping and dressing in a more provocative fashion.

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