bipolar

Question 1

risk factors for bipolar

Answer 1

genetics, neurotransmitters, neurobiology, endocrine, environmental factors

Question 2

what is bipolar 1?

Answer 2

most severe form, with the highest mortality rate, and must have at least 1 manic episode

Question 3

what is bipolar 2?

Answer 3

at least 1 hypomanic episode and 1 major depressive disorder.

more severe than cyclothyamic

Question 4

what is cyclothyamic disorder?

Answer 4

alternate symptoms of mild to moderate depression for at least 2 years. rapid cycling is possible

Question 5

what is the diagnostic criteria for bipolar 1?

Answer 5

1. at least one MANIC episode
2. three or more of symptoms
3. symptoms cause an impairment in functioning or require hospitalization

Question 6

what are the clinical features of mania?

Answer 6

D-distractibility
I-indiscretion
G-grandiosity
F-flight of ideas
A-activity increase
S-sleep deficit
T-talkativeness

Question 7

how is someone diagnosed with bipolar 2?

Answer 7

presence of at least 1 major depression episode and at least one hypomanic episode

NEVER MANIC

Question 8

what differentiates a manic episode from a hypomanic episode?

Answer 8

• not severe enought to impair social or occupational functioning
  -not severe enough to need hospitalization
  -no psychotic features

Question 9

what is mixed features in regards to bipolar?

Answer 9

showing signs of depression and mania at the same time

Question 10

cyclothiamic disorder s/s

Answer 10

present for at least 2 years
-multiple hypomanic symptoms (not an episode)
-symptoms present more than half the time (no more than 2 months without)
-

Question 11

what are possible moods with bipolar?

Answer 11

mania, hypomania, depression, lability

Question 12

what are possible behaviors with bipolar?

Answer 12

agitated, manipulative, restless, pacing

Question 13

what are possible thought processes with bipolar?

Answer 13

loose, tangential, and flight of ideas

Question 14

what are possible thought contents with bipolar?

Answer 14

grandiose, paranoid, and persecutory

Question 15

what are possible speech patterns with bipolar?

Answer 15

pressured, circumstantial, and clang

Question 16

what medications are used for acute mania?

Answer 16

lithium or divalproex plus an antipsychotic

(Benzos if extreme agitation)

Question 17

what meds are used for mood stabilization?

Answer 17

divalproez
carbamazepine
lamotrigine
gabapentin
LITHIUM CARBONATE

Question 18

what are the contraindications for lithium?

Answer 18

CVD, renal disease, brain damge, thyroid disease, pregnant or breast-feeding

Question 19

what are the early signs of lithium toxicity?

Answer 19

GI upset, coarse hand tremor, confusion, hyperirritability, EKG changed, sedation, and incoordination

Question 20

how do we treat lithium toxicity early?

Answer 20

stop meds and send blood for labs

Question 21

what are the advanced signs of lithium toxicity?

Answer 21

ataxia, giddiness, EKG changes, clonic movements, large urine output, severe hypotension, seizure, stupor, coma,

Question 22

how do we treat advanced lithium toxicity

Answer 22

hospitalized, drug is stopped, whole bowel irrigation to prevent further absorption

Question 23

what is the nursing consideration for divalproex

Answer 23

check serum levels,

Question 24

s/e of carbmazepine

Answer 24

risk for low WBC
check hepatic and renal function
Rash

Question 25

what is the major effect with lamotrigine?

Answer 25

RASH!!!

deadly by leading to steven johnson syndrome

Stop med