What priority finding should a nurse report for a client with bipolar disorder experiencing mania?

In a client with bipolar disorder experiencing mania, refusing to drink fluids is a significant priority finding. Dehydration can lead to severe complications, especially in a manic state where impulsivity and reduced awareness of physical needs are common. Mania may lead clients to neglect their basic self-care, including fluid intake, which is crucial for maintaining physiological balance and preventing deterioration in health.

While excessive spending, grandiosity, and disrupted sleep patterns are important behaviors to monitor in manic episodes, they do not pose an immediate threat to the client's physical health in the same way that refusing to drink fluids does. The refusal to hydrate can cause rapid physiological changes, such as electrolyte imbalances, kidney issues, and other serious health concerns. Therefore, the nurse must prioritize reporting fluid refusal to ensure the client receives prompt evaluation and intervention.