Chapter 69, Caring for Clients With Mood Disorders.

1.A client with major depression is having a disturbed sleep pattern. Which of the following nursing interventions will help the client to get maximum sleep during the night? A) Acknowledge the client's feeling of despair. B) Encourage active exercise before bedtime. C) Encourage the client to go to bed early. D) Keep the client busy during the day. Ans: D Feedback: The nurse should keep the client busy during the day and discourage the client from going to bed early. Left alone, depressed clients are likely to become more vegetative (i.e., they withdraw by sleeping). The nurse should also encourage active exercise during the day but not before bedtime. Exercise relieves anxiety but it may cause stimulation when performed at night. Recognizing a client's mood demonstrates that the nurse has noticed the person and is perceptive but will not help a client with depression in this situation. 2.A client with bipolar disorder is having a disturbed thought process. Which of the following nursing interventions can help the client to be oriented and accurately perceive circumstances surrounding admission? A) Provide ample information. B) Support the client when in delusion. C) Reduce distracting stimuli. D) Offer a large-muscle activity. Ans: C Feedback: The nurse should reduce distracting stimuli such as noise and stimulation. External stimuli potentiate client's internal activity. The nurse should not provide ample information at once, but rather should provide information in small amounts, using brief sentences. Brief discussion accommodates short attention span. The nurse should also present reality when the client is delusional and should not support the delusion of the client. Failing to present reality reinforces that the client's delusions are real. Exercise releases energy and reduces the potential for an angry outburst. It will not help a client with disturbed thought processes to be oriented. 3.Which of the following nursing interventions should a nurse perform when caring for a female client with mood disorder who is prescribed lithium?