Rationales to learn from - view them as “Truth Statements”

A client experiencing mania requires a __________ environment (no noise, lights, or people).

low-stimuli

Physical exhaustion is a life-threatening risk of mania, so the nurse must encourage __________ throughout the day.

frequent, short rest periods

During acute mania, clients should be offered high-calorie, high-protein _________ to prevent calorie deficits.

finger foods

Manifestations of acute mania include __________, bizarre or uncoordinated dress, and disorganized speech.

weight loss

Flight of ideas involves continuous, abrupt changes from __________ with disorganized speech.

topic to topic

Grandiosity is an inflated self-regard where clients exaggerate achievements and may claim, 'I feel like __________.'

Superman

Hypomania is characterized by euphoria, increased psychomotor activity, and an inflated sense of self-importance, but not __________.

hallucinations

Interventions for mania should include solitary, structured activities and __________ with a nurse.

walking

Depressive episodes in Bipolar II typically present with extreme agitation, insomnia, seasonal mood shifts, and __________.

suicidality

Lithium carbonate is the first-line treatment for acute depressive episodes in bipolar disorder because antidepressants can induce _________ or mania.

hypomania

Staying with the client ensures safety; __________ monitor nutritional status, and seclusion is used strictly as needed.

daily weights

Acute psychosis is hallmarked by __________ that are not actually present.

false sensory perceptions

Positive manifestations of schizophrenia include neologisms, echolalia, clang associations, and __________.

word salad

Command hallucinations involve voices instructing the client to perform actions; the nurse must assess the risk of __________.

self-harm or aggression toward others

When a client experiences hallucinations, the nurse should never argue with the voices, negate reality, or act as if the __________ is real.

hallucination

Loose associations indicate __________ and cognitive alteration, making them a priority to report due to safety threats.

disorientation

Delusions of __________ involve the false belief that others intend to cause the client harm.

persecution

First-generation antipsychotics block dopamine D2 receptors to treat positive manifestations like __________.

hallucinations

Haloperidol can be used to treat aggression and psychosis during acute manic phases, but it carries a high risk of __________.

extrapyramidal symptoms (EPS)

Tardive dyskinesia, characterized by protruding tongue and irregular limb movements, is a serious movement disorder associated with __________.

first-generation antipsychotics

Second-generation antipsychotics target both positive and negative manifestations and have a lower risk of __________.

EPS

Clients taking second-generation antipsychotics should never stop them __________ or consume alcohol/CNS depressants.

abruptly

Clozapine is used for treatment-resistant schizophrenia and carries a major risk for severe __________.

agranulocytosis

Adverse effects of clozapine include tachycardia, muscle rigidity, fever, and increased __________.

salivation

Lithium carbonate limits sodium reabsorption in the kidneys; clients must maintain consistent, normal __________ intake.

sodium

Clients taking lithium must maintain hydration (1500 to 3000 mL/day) and avoid __________ to prevent toxicity.

crash dieting

Early signs of lithium toxicity include diarrhea, lethargy, muscle weakness, nausea, and __________.

slurred speech

A blood lithium level greater than __________ indicates toxicity; the nurse must withhold the medication and notify the provider.

1.5 mEq/L

Furosemide lowers sodium levels, which reduces lithium excretion and causes __________.

toxic accumulation

Fluoxetine (an SSRI) takes __________ to show effects, may cause sedation, and can lead to sexual dysfunction.

1 to 3 weeks

Sertraline (an SSRI) carries a black box warning for an increased risk of __________.

suicidal ideation

Bupropion is contraindicated in clients with a history of head trauma, seizure disorders, or eating disorders due to increased __________ risk.

seizure

Monoamine oxidase inhibitors (MAOIs) require avoiding foods high in __________ to prevent hypertensive crisis.

tyramine

Suicide risk assessments must directly ask clients about their methods, such as 'How will you carry out your __________?'

plan

Impulsivity drastically increases suicide risk as clients may act quickly without considering __________.

consequences

Risk factors for suicide include major depressive disorder, unemployment, and access to __________.

firearms

Suicide precautions include using plastic utensils and assigning the client to a __________ room with the door open.

semi-private

Therapeutic communication for suicide attempt clients may involve questions like 'Would you like to talk about __________?'

what happened