一位處於躁鬱症躁期(Manic phase)的個案,在走廊踱步並大聲提出要求。哪些護理措施是適當的?(選所有適合的)
A client in the manic phase of bipolar disorder is pacing the halls and making loud, demanding comments. Which nursing actions are appropriate? (Select all that apply.)
- AProvide high-protein, finger-food snacks✓ 正解提供高蛋白的手指食物零食
- BEstablish firm, consistent limits on behavior✓ 正解對行為設立堅定且一致的界限
- CEngage the client in a competitive group board game讓個案參與競爭性的團體桌遊
- DReduce environmental stimuli by placing the client in a quiet area✓ 正解將個案安置於安靜區域以降低環境刺激
- ESpeak to the client in short, simple, and direct sentences✓ 正解用簡短、簡單且直接的句子與個案交談
躁鬱症躁期(Manic phase)的病人能量過剩、注意力分散、情緒易怒且行為衝動。護理照護重點在於:提供結構化環境以降低刺激(D);提供高熱量手拿食物(A)以確保其活動過多時的營養;以簡短、清晰的句子與其溝通(E),避免因長篇大論而產生衝突;並設定堅定且一致的邊界(B),以管理其破壞性行為。競爭性遊戲(C)會過度刺激病人,不適合。
A patient in the manic phase of bipolar disorder exhibits excessive energy, distractibility, irritability, and impulsive behavior. Nursing care focuses on: providing a structured environment to reduce stimuli (D); offering high-calorie finger foods (A) to ensure adequate nutrition during hyperactivity; communicating in short, clear sentences (E) to avoid conflict that may arise from lengthy explanations; and setting firm and consistent limits (B) to manage disruptive behavior. Competitive games (C) overstimulate the patient and are inappropriate.