A nurse is caring for a client who has bipolar disorder. The nurse is planning care for the client. Select the 4 interventions the nurse should include in the client’s care.

Choice A reason: Sitting with the client during mealtimes is an essential intervention because clients with bipolar disorder, especially during manic episodes, often have poor appetite and difficulty focusing long enough to eat. Direct support ensures nutritional intake, prevents further weight loss, and provides structure. It also reduces the risk of malnutrition and dehydration, which are common complications in manic states. Choice B reason: Turning on the television for the client is not therapeutic. Clients in manic episodes are easily overstimulated, and television can increase agitation, distractibility, and hyperactivity. Instead of calming the client, it may worsen confusion and disorientation. Therefore, this intervention is inappropriate. Choice C reason: Removing sharp objects from the client’s room is a critical safety measure. Clients with bipolar disorder experiencing mania may act impulsively, and the risk of self-harm or accidental injury is high. Ensuring the environment is free of dangerous objects reduces the likelihood of harm and supports safe management of the client’s agitation. Choice D reason: Observing the client every 15 minutes is necessary for safety monitoring. The client is hyperactive, confused, and disoriented, which increases the risk of injury, aggression, or unpredictable behavior. Frequent observation allows early detection of escalating agitation and ensures timely intervention. This is a standard safety protocol in acute psychiatric care. Choice E reason: Providing a low-protein diet is not indicated. Clients with bipolar disorder do not require protein restriction; in fact, adequate protein intake is important for maintaining energy and nutritional balance. Restricting protein could worsen malnutrition and weight loss. This intervention is inappropriate. Choice F reason: Offering the client physical activities is beneficial because it provides a safe outlet for excess energy during manic episodes. Structured physical activity helps reduce agitation, channel hyperactivity, and promote better sleep. It also decreases restlessness and supports overall emotional regulation. Activities should be simple, noncompetitive, and safe to avoid overstimulation.