Final answer:
In the context of bipolar I disorder's manic phase, 'Racing thoughts and impulsivity' is the sign that requires immediate intervention by the nurse due to the risk of potential harm stemming from unchecked impulsive actions. C) Racing thoughts and impulsivity
Step-by-step explanation:
The nurse is caring for a client with bipolar I disorder in the manic phase. Among the options provided, the sign of escalating behavior that requires immediate intervention is "C) Racing thoughts and impulsivity." This behavior is concerning because it can lead to harm to the patient or others, due to the potential for engaging in risky or harmful activities without considering the consequences.
Racing thoughts may contribute to rapid speech and a flurry of ideas, which can be overwhelming and disorienting. Impulsivity, which is characterized by sudden actions without premeditation, can lead to dangerous situations, such as substance abuse or reckless driving. It's crucial for healthcare providers to intervene promptly when these signs are observed to ensure the safety of the client and others.
An elevated mood and grandiosity (Option B) can be typical of a manic phase, but do not inherently represent an immediate risk. Increased talkativeness (Option A) and increased goal-directed activity and productivity (Option D), while part of the symptomatology, are not as immediately dangerous as the loss of impulse control that comes with racing thoughts and impulsivity.