What should the nurse do next when a client with acute mania refuses to lie down and becomes disruptive?

In a situation where a client with acute mania is refusing to lie down and becomes disruptive, prioritizing safety and managing the environment is crucial. When a client is in a manic state, their behavior can often escalate to include agitation or aggression, which can put both the client and others at risk.

Choosing to seclude the client and use restraints, if necessary, is a method that is sometimes employed in mental health settings to ensure the safety of the individual and those around them. This approach helps in providing a controlled environment where the client can be monitored, offering a space for the individual to settle down without the influence of external stimuli that may further exacerbate their manic symptoms. It is a response that acknowledges the severity of the situation and aims to prevent potential harm while also enabling the staff to manage the situation effectively.

The other options lack an adequate focus on safety and may not be conducive to de-escalating the situation effectively. For instance, simply following the client and asking her to calm down may not be effective, especially if she is in a heightened manic state. Additionally, instructing her to lie down may feel dismissive to her needs and could further provoke her disruptive behavior. Ignoring the client’s remarks might lead to feelings of abandonment or confusion