Bi-polar and Schizophrenia Flashcards
A condition that causes uncontrolled body movements. (tremors, tongue-rolling)
tardive dyskinesia (s/e of EPS)
motor restless (s/s of EPS)
Akathisis
disordered tonicity of muscles (continuous spasms and muscle contraction)
Dystonia
Out of touch with reality with delusions or hallucinations and disorganized thinking
Psychosis
What to do during a Psychotic episode?
▫️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
A mood cycles with extremes of mania and depression with norms in between
Bipolar disorder
▫️1st onset usually in early 20’s
▫️occurs =ly in men and women
▫️strong genetic component
treatment for bipolar
combination of medication and psychotherapy is more effective
Psychopharmacology for bipolar
▫️mood stabilizers (lithium for manic phase)
▫️antidepressants
▫️antipsychotics
Psychotherapy for bipolar disorder
▫️cognitive behavioural therapy
▫️family-focused therapy
▫️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
Electroconvulsive therapy (ECT)
disorder involves extreme mood swings from episodes of mania to episodes of depression. Formerly known as manic-depressive illness
Bipolar disorder
During manic phases, client with bipolar :
▫️euphoric
▫️grandiose
▫️energetic
▫️sleepless
they have poor judgement and rapid thoughts, actions and speech
During depressed phases, bipolar clients:
▫️mood, behaviour, and thoughts are the same as in people diagnosed with major depression
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
Lithium
The client may wear clothes that reflect the elevated mood: brightly coloured, flamboyant, attention-getting, and perhaps sexually suggestive
▫️think, move and talk fast
Bipolar: manic phase
▫️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.
Pressured speech (bipolar)
is reflected in periods of euphoria, exuberant activity, grandiosity, and false sense of well-being
Mania
Clients with mania have short attention span. So nurse uses:
▫️clear, simple sentences when communicating
▫️nurse breaks information into many small segments
lithium range of safety maintenance levels (0.5 to 1 mEq/L
treatment levels (0.8 to 1.5 mEq/L
toxic levels (1.5 and above
evaluation of the treatment of bipolar disorders includes but not limited to the ff:
- 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.
what is anhedonia
lack of pleasure in normal activities