Food she can eat on the move
A client in acute mania is hyperactive, distractible, and unable to sit still long enough to finish a meal. This woman has slept only 2 to 3 hours a night for 10 days, talks almost nonstop, and has lost 3 kg in the past week because she will not sit down to eat. Her energy use is very high while her intake is very low. High-calorie, high-protein finger foods and portable drinks that she can take while walking meet her energy needs without requiring her to sit. Examples include sandwiches, fruit, cheese, and nutritious shakes that can be carried.
Why this approach works
Mania increases physical activity and metabolic demand and reduces attention to bodily signals such as hunger and thirst. Rather than fighting her restlessness, the plan adapts to it. Finger foods can be offered frequently in small amounts, eaten without utensils, and carried as she walks. Fluids are offered regularly to prevent dehydration, which is especially important if she is started on lithium. Daily weights and records of intake allow the nurse to judge whether the plan is working.
| Option | Problem |
|---|
| High-calorie finger foods and drinks while walking | Correct: meets needs without requiring her to sit |
| Three full meals at a table with staff | She cannot sit through a full meal during acute mania |
| Keeping her seated until she finishes | Invites a power struggle and does not get food into her |
| Waiting until she feels hungry | Mania blunts hunger; weight loss worsens |
Why the other plans fail
Three full meals at a table, even with a staff member beside her, still require her to sit, which she cannot do at this stage. Insisting that she stay seated until her tray is finished creates a power struggle, increases agitation, and is unlikely to result in more food eaten. Waiting until she feels hungry ignores the fact that mania blunts awareness of hunger; she is already losing weight, and waiting would deepen the deficit.
Watch out! Reduce stimulation at mealtimes when possible, since the busy dining room adds to her distractibility. Some clients do better eating in a quieter area, but the priority remains getting calories in, not enforcing a setting.
Exam takeaway
Key point! For a client in acute mania, offer high-calorie, high-protein finger foods and portable drinks frequently, and monitor weight and intake daily. Avoid power struggles over sitting or finishing a tray.