If the client's manic episode is severe, causing significant impairment or posing a risk to themselves or others, an emergency room visit is recommended.
When the client's spouse calls the health clinic stating that the client is having a manic episode, the nurse should gather specific information to assess the severity of the situation and determine whether an emergency room visit is warranted. Here are some key pieces of information to gather:
Duration and intensity of manic symptoms: The nurse should inquire about the duration of the manic episode and how intense the symptoms have been. A prolonged manic episode with escalating symptoms raises concerns about the client's safety and the need for immediate intervention.
Specific manic symptoms: The nurse should ask about the specific manic symptoms the client is experiencing. These may include:
Elevated mood: The client may exhibit excessive euphoria, excitement, or irritability.
Increased activity: The client may be hyperactive, engaging in restless behavior or excessive talking.
Racing thoughts: The client may have a rapid flow of thoughts, making it difficult to focus or complete tasks.
Decreased need for sleep: The client may experience a significantly reduced need for sleep, staying awake for extended periods.
Grandiosity: The client may have inflated self-esteem or unrealistic beliefs about their abilities.
Impulsive behavior: The client may engage in impulsive or risky behaviors, such as reckless spending, substance abuse, or promiscuity.
Potential for harm to self or others: The nurse should assess whether the client poses a risk to themselves or others. This includes evaluating their mood, behavior, and any recent threats or violence.
Past history of mania or bipolar disorder: If the client has a history of mania or bipolar disorder, the nurse should inquire about their past experiences with manic episodes and their usual treatment plan.
Current medications: The nurse should determine if the client is taking any medications for bipolar disorder or other mental health conditions and whether they are taking them as prescribed.
Based on the gathered information, the nurse can make a judgment about the severity of the manic episode and the client's immediate needs. If any of the following factors are present, the nurse should strongly recommend that the client seek emergency room treatment:
The manic episode is severe and causing significant impairment in the client's daily life.
The client is exhibiting psychotic symptoms, such as delusions or hallucinations.
The client is expressing thoughts of harming themselves or others.
The client is engaging in impulsive or risky behaviors that could put them at risk.
In such cases, the nurse should provide the client and their spouse with clear instructions on how to access emergency mental health services and offer to assist in making arrangements if necessary. Prompt intervention can help prevent harm and promote a safe and effective recovery from the manic episode.