護理師正在照護一名處於躁期（manic episode）的雙相情緒障礙症個案。下列哪些護理措施應包含在照護計畫中？（選所有適合的）
A nurse is caring for a client with bipolar disorder during a manic episode. Which interventions should the nurse include in the care plan? (Select all that apply.)
- AProvide high-calorie, finger foods that are easy to carry✓ 正解提供易於攜帶的高熱量手指食物
- BReduce environmental stimuli by placing the client in a quiet room✓ 正解將個案安置於安靜房間以降低環境刺激
- CEncourage the client to engage in competitive group activities鼓勵個案參與競爭性團體活動
- DSet firm, consistent limits on inappropriate behaviors✓ 正解對不當行為設定堅定且一致的界線
- EMonitor for signs of exhaustion due to constant activity✓ 正解監測因持續活動所導致之疲憊跡象
躁期（Manic episode）個案的核心護理目標為安全、營養攝取及減少刺激。個案因處於過度活躍狀態，容易忽略生理需求，因此護理措施應聚焦於維持基本生存需求與環境控管。正確選項皆針對個案躁動特徵設計：提供手拿食物以應對其無法靜坐進食的狀況；減少環境刺激以協助穩定情緒；設立界線以維護安全與社交規範；監測生理疲憊以防過度耗竭。競爭性活動會增強個案的競賽心態與躁動，故應避免。
The core nursing goals for a client in a manic episode are safety, adequate nutritional intake, and reduction of stimulation. Because clients are excessively hyperactive, they often neglect physiologic needs; nursing interventions should therefore focus on maintaining basic survival needs and environmental control. The correct options all address the characteristics of mania: providing finger foods accommodates the client's inability to sit still to eat; reducing environmental stimuli helps stabilize mood; setting firm limits maintains safety and reinforces social norms; and monitoring for exhaustion prevents overexertion. Competitive activities increase competitiveness and agitation and should be avoided.
在美國臨床環境中，針對躁期病人，護理師更強調「Milieu Therapy」（環境治療）的運用，即透過調整環境結構來管理病人的行為。台灣臨床有時會過度依賴藥物控制，而美國更強調在藥物介入的同時，透過護理計畫主動管理病人的活動空間與社交刺激。