Care Plan

Topics: Attention, Nursing care plan, Nursing Pages: 15 (2540 words) Published: June 29, 2013

Bipolar Disorder, Manic Episode


Risk for Other-Directed Violence
At risk for behaviors in which an individual demonstrates that he or she can be physically, emotionally, and/or sexually harmful to others.


Hostile behavior
Threatened or actual aggression toward self or others
Low self-esteem



The client will

Be safe and free from injury throughout hospitalization
Demonstrate decreased restlessness, hyperactivity, and agitation within 24 to 48 hours •Demonstrate decreased hostility within 2 to 4 days
Refrain from harming others throughout hospitalization


The client will

Be free of restlessness, hyperactivity, and agitation
Be free of threatened or actual aggression toward self or others


The client will

Demonstrate level moods
Express feelings of anger or frustration verbally in a safe manner


|Nursing Interventions |Rationale | |* denotes collaborative interventions | | |Provide a safe environment. See Care Plan 26: Suicidal Behavior, |Physical safety of the client and others is a priority. The client | |Care Plan 46: Hostile Behavior, and Care Plan 47: Aggressive |may use many common items and environmental situations in a | |Behavior. |destructive manner. | |Administer PRN medications judiciously, preferably before the |Medications can help the client regain self-control but should not be| |client’s behavior becomes destructive. |used to control the client’s behavior for the staff’s convenience or | | |as a substitute for working with the client’s problems. | |Set and maintain limits on behavior that is destructive or adversely|Limits must be established by others when the client is unable to use| |affects others. |internal controls effectively. The physical safety and emotional | | |needs of other clients are important. | |Decrease environmental stimuli whenever possible. Respond to cues of|The client’s ability to deal with stimuli is impaired. | |agitation by removing stimuli and perhaps isolating the client; a | | |private room may be beneficial. | | |Provide a consistent, structured environment. Let the client know |Consistency and structure can reassure the client. The client must | |what is expected of him or her. Set goals with the client as soon as|know what is expected before he or she can work toward meeting those | |possible. |expectations. | |Give simple direct explanations (e.g., for procedures, tests, etc.).|The client is limited in the ability to deal with complex stimuli. | |Do not argue with the client. |Stating a limit tells the client what is expected. Arguing interjects| | |doubt and undermines limits. | |Encourage the client to verbalize feelings such as anxiety and |Ventilation of feelings may help relieve anxiety, anger, and so | |anger....
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