Bi-polar and Schizophrenia

Question 1

A condition that causes uncontrolled body movements. (tremors, tongue-rolling)

Answer 1

tardive dyskinesia (s/e of EPS)

Question 2

motor restless (s/s of EPS)

Answer 2

Akathisis

Question 3

disordered tonicity of muscles (continuous spasms and muscle contraction)

Answer 3

Dystonia

Question 4

Out of touch with reality with delusions or hallucinations and disorganized thinking

Answer 4

Psychosis

Question 5

What to do during a Psychotic episode?

Answer 5

▫️remain calm
▫️decrease distractions: TV, radio etc.
▫️ask other to leave/give person personal space
▫️speak one at a time
▫️try saying: “let’s sit down and talk”
▫️speak slowly and clearly in a normal voice; don’t shout, argue, or criticize
▫️make statement about observed behaviour: “you must be afraid (angry, confused)”
▫️don’t make continuous eye contact

Question 6

A mood cycles with extremes of mania and depression with norms in between

Answer 6

Bipolar disorder

▫️1st onset usually in early 20’s
▫️occurs =ly in men and women
▫️strong genetic component

Question 7

treatment for bipolar

Answer 7

combination of medication and psychotherapy is more effective

Question 8

Psychopharmacology for bipolar

Answer 8

▫️mood stabilizers (lithium for manic phase)
▫️antidepressants
▫️antipsychotics

Question 9

Psychotherapy for bipolar disorder

Answer 9

▫️cognitive behavioural therapy

▫️family-focused therapy

Question 10

▫️Usually a Last resort treatment for bipolar.
▫️When taking medications poses a risk.
▫️When symptoms are resistant to medication
▫️when patients are non-compliant with medication
▫️when patients have a high risk of suicide with medication

Answer 10

Electroconvulsive therapy (ECT)

Question 11

disorder involves extreme mood swings from episodes of mania to episodes of depression. Formerly known as manic-depressive illness

Answer 11

Bipolar disorder

Question 12

During manic phases, client with bipolar :

Answer 12

▫️euphoric
▫️grandiose
▫️energetic
▫️sleepless

they have poor judgement and rapid thoughts, actions and speech

Question 13

During depressed phases, bipolar clients:

Answer 13

▫️mood, behaviour, and thoughts are the same as in people diagnosed with major depression

Question 14

not only competes for salt receptor sites but also affects calcium, potassium, and magnesium ions as well as glucose metabolism.
It is thought to work in the synapses to hasten destruction of catecholamines (dopamine, norepinephrine), inhibit neurotransmitter release, and decrease the sensitivity of postsynaptic receptor s

Answer 14

Lithium

Question 15

The client may wear clothes that reflect the elevated mood: brightly coloured, flamboyant, attention-getting, and perhaps sexually suggestive

▫️think, move and talk fast

Answer 15

Bipolar: manic phase

Question 16

▫️is evidenced by unrelenting rapid and often loud speech without pauses.
▫️interrupt and cannot listen to others
▫️they ignore verbal and non-verbal cues indicating that others wish to speak, and they continue with constant intelligible or unintelligible speech, turning from one listener to another or speaking to no one at all.

Answer 16

Pressured speech (bipolar)

Question 17

is reflected in periods of euphoria, exuberant activity, grandiosity, and false sense of well-being

Answer 17

Mania

Question 18

Clients with mania have short attention span. So nurse uses:

Answer 18

▫️clear, simple sentences when communicating

▫️nurse breaks information into many small segments

Question 19

lithium range of safety maintenance levels (0.5 to 1 mEq/L

Answer 19

treatment levels (0.8 to 1.5 mEq/L

toxic levels (1.5 and above

Question 20

evaluation of the treatment of bipolar disorders includes but not limited to the ff:

Answer 20

• safety issues
• comparison of mood and affect between start of treatment and present
• adherence to treatment regimen of medication and psychotherapy
• changes in clients perception of quality of life.
• achievement of specific goals of treatment including new coping methods.

Question 21

what is anhedonia

Answer 21

lack of pleasure in normal activities