Bipolar Flashcards
What is mood defined as
A pervasive and sustained emotion that may have a major influence on a persons perception of the world
Ex.
Depression, joy, anger, anxiety
What is affect?
Described as the emotional reaction associated with an experience
What is mania
Alteration, in mood that may be expressed by feelings of elation, inflation, self-esteem, grandiosity, hyperactivity, agitation, racing thoughts, and accelerated speech
What is the average onset of bipolar
25 years
What is bipolar disorder characterized by?
Mood swings from profound depression to extreme euphoria(mania) with intervening periods of normalcy
What is the somewhat milder form of mania called?
Hypomania
What is bipolar I disorder
Given to an individual who is experiencing a manic episode or has a history of one or more manic episodes
Client may also have experienced episodes of depression
What is it described as when you have your first episode of mania
Single manic episode
What is bipolar II disorder?
Characterized by recurrent bouts of major depression, with episodic occurrence of hypomania
Client has never experienced a full manic episode
Symptoms are not severe enough, Mark impairment, and social or occupational functioning or necessary hospitalization
What is the DSM five criteria for manic episode?
Abnormal and persistently elevated or irritable mood, and abnormally and persistent, increase cold, directed activity or energy lasting at least one week in present most of the day nearly every day
The DSM five states during a period of mood disturbance in increase energy, three or more of the following symptoms are present to significant degree and represent a noticeable change from usual behavior
Inflated, self-esteem, or grandiosity
Decreased need for sleep
More talkative than usual or pressure to keep talking
Flight of ideas thoughts are racing
Distractibility
Increase in directed activity
Excessive involvement in activities that have high potential for pain consequences
What is cyclothymic disorder?
Chronic mood disturbance of at least two years involving numerous periods of elevated mood that do not meet the criteria of a hypomania episode, and numerous periods of depressed mood insufficient to meet criteria for major depressive order
Individual is never without symptoms for more than two months
What is the difference between hypo maniac and mania?
Symptoms in hypomania need to be lasting, at least four consecutive days present most of the day nearly every day
Not severe enough to cause impairment, and social or occupational functioning
What is substance medicated induced bipolar disorder
Mood associated with disorder is considered to be directed result of effects of substance
What is bipolar disorder due to another medical condition
Characterized by abnormal, persistent, elevated expensive or irritable mood, excessive activity or energy, judged by the direct physical logical consequences of another medical condition
Include thyroid disorder, stroke, TBI, MS, lupus aids
The suicidal client with a history of manic behavior is admitted to the emergency department. The the Clydes diagnosis is documented as 54 disorder, current episodes depressed what is the rationale for the diagnosis instead of a diagnosis of major depressive disorder
Physician does not believe that the patient is suffering for major depress
Patient has experienced a manic episode in the past
Patient does not exhibit psychotic symptoms
No history of major depression in the patient’s family
Patient has experienced a manic episode in the past
What is a biochemical influence of a predisposing factor to bipolar
Possible excess of no epinephrine and dopamine
Serotonin is believed to remain low
Why are children and adolescence difficult to diagnose with bipolar?
Diagnosis often manifested with host of atypical symptoms, including nondiscrete, mood, episodes, chronic irritability, and temper tantrums
What is the most common comorbidity in children and adolescence with bipolar disorder
ADHD, many of the symptoms, particularly distractibility inattention impulsivity, overlap
L ADHD agents may exacerbate mania, which should be done
Medication for ADHD should be initiated only after bipolar symptoms have been controlled with mood stabilizing agents
What is the treatment of acute mania in children and adolescence?
Lithium, risperidone aripiprazole olanzapine
What are the only two medications approved for treatment of bipolar, depression, in children and adolescence?
Olanzapine fluoxetine
Medication treatment for bipolar, depression, and children is controversial what are some non-formal logical interventions
Mood, charting managing stress and sleep cycles, maintaining healthy, diet and exercising, avoid alcohol and drugs
What is the first stage of a manic state?
Stage one hypomania
Disturbance is not sufficiently severe to cause marketed impairment and social, occupational functioning or required hospitalization
What happens to the mood in stage one hypomania
Cheerful inexpensive, but an underlying irritability surfaces rapidly when the persons wishes and desires, go unfulfilled
What is the cognition and perception of stage one hypomania
Perceptions of self are exalted individual has ideas of great worth inability, thinking is flighty, and rapid perception of environment is heightened, easily distracted
What is the activity and behavior of a stage one hypomania
Individuals exhibit increase motor activity
Extroverted and sociable
Lack depth of personality and warmth to formulate close friendships
Talk a lot and loudly and inappropriately
Experience, anorexic, and weight loss
Engage in inappropriate behaviors, such as phoning president of USA
Or spending a lot of money
What is the second stage of a manic state
Acute mania may progress intensification from those experience in hypomania
Most experience marked impairment and functioning and require hospitalization
What is the mood in stage two acute mania
Characterized by euphoria in elation, appears to be continuously high mood is subjective, frequent variation, easily changing to irritability and anger, even sadness and crying
What is the cognition in perception in stage two acute mania
Technician and perception, because fragmented often psychotic
Accelerated thinking, proceeds to racing thoughts, rapid of abrupt movement from thought to another (flight ideas)
Pressured speech to the point conversing may be difficult disorganized and incoherent speech
Distractibility
Hallucinations and delusions, usually paranoid and grandiose
What is it called when you have a rapid abrupt movement from one thought to another
Flight of ideas
What is it called when you have a continuous flow of accelerated pressure speech
Loquaciousness
What is the activity and behavior like in stage two acute mania
Psycho motor activity excess
Sexual interest increased
Poor impulse control, low frustration tolerance
Excessive spending
Little insight into his or her behavior
Lack of insight
Denial of problems
Energy seems in exhaustible need for sleep diminished
Hygiene and grooming neglected
Dress may be disorganized, slim, and bizarre
Excessive make up or jewelry
What is stage three of a manic state?
Delirious mania
Serious form of disorder, characterized by severe clouting of conscious in intensification of symptoms
What is the mood of stage three delirious mania?
Very liable exhibits feelings of despair, quickly converting to unrestrained ecstasy, or becoming irritable, and totally indifferent to the environment
Panic level anxiety
What is the cognition and perception of a stage three delirious mania?
Characterized by clouding of conscience with a company, confusion, disorientation, and sometimes super
Manifestations, including religiosity, delusions of grandeur, persecution in auditory or visual hallucination
Individual is extremely distractibility and incoherent
What is the activity in behavior of a stage three delirious mania
Psycho motor activities, frenzied, characterized by agitated purposeless, movement safety is at stake unless activity is stopped
exhaustion injury to self or others, and eventually death can occur without intervention
What are some outcome following the diagnosis of bipolar
No evidence of physical injury, or self harm to self or others
No longer exhibiting signs of physical agitation
Well balanced diet with snacks to prevent weight loss
Except responsibilities for own behaviors
Is not manipulative
Falls asleep within 30 minutes
Able to sleep six hours without medication
In the initial stages of caring for a client experiencing an acute manic episode, which of the nurse consider to be a priority, nursing diagnosis
Risk for injury related to excessive hyper activity
Disturbed sleep, pattern related to manic hyperactivity
In balance nutrition, less than body requirements, related to inadequate intake
Low self-esteem related to embarrassment secondary to high-risk behaviors
Risk for injury related to excessive hyperactivity
What are some interventions for risk for violence?
Remove all dangerous objects
Maintain, calm attitude
Restrain is the necessary, ensure sufficient staff
What are some interventions for? Impaired social interaction
Set limits are manipulative behaviors
Do not argue, bargain, or try and reason
Provide positive reinforcement
What are some interventions for imbalance nutrition?
Provide patient with high protein, high calorie food
Accurate record of intake, output, and calorie count
Monitor sleep patterns
What is concept care mapping?
Diagrammatic, teaching, and learning strategy that allows visualization of relationship between medical diagnosis nursing diagnosis, assessment, data and treatments
 how does individual psychotherapy treatment for bipolar disorder?
Psychotherapies in conjunction with medication treatment have better outcomes then medication
What is IPSRT and how does it help in bipolar treatment
Interpersonal and social rhythm therapy
Specifically designed for bipolar clients
Focuses on helping clients regulate, social rhythms, or daily activities, such as sleep, wakefulness cycle and exercise routines. That may otherwise disrupt underlying biological rhythms, and contribute to disturbances
Is group therapy effective in treatment of bipolar
Once in acute phase of illness has passed, group can be can be provided to discuss issues in their lives, that cause, maintain or arise from having serious effective disorder
How does family therapy help in the treatment of bipolar?
Resolve symptoms and initiate or restore adaptive Family 🏠 functioning family treatment combined with medication substantially reduces relapse rates
Family functioning is often disrupted in clients due to disloyalty financial problems and excessive spending family needs to be involved for education, support and therapy
How is cognitive behavioral therapy a treatment for bipolar
Goal is to change, automatic thoughts
Individual is taught control thought distortions that are considered a factor and development and maintenance of mood disorders. Obtain symptom relief as quickly as possible assist. Client in identifying dysfunctional patterns of thinking and behaving, guide the client to evidence, logic and effective test, the fidelity of dysfunctional thinking.
What are some examples of automatic thoughts in bipolar mania?
Personalizing: I’m the only reason my husband is a successful businessman
All or nothing : everything I do is great
Mind reading : she thinks I’m wonderful
Discounting negatives : none of those mistakes are really important
What is ECT?
Electroconvulsive therapy use, particularly when client does not tolerate or fails to respond to lithium or other direct treatments
What is bright light therapy
May have benefits for patients with bipolar depression,
may reset areas of brain associated with circuit and rhythm regulation
What are medication’s taken for mania?
Lithium carbonate
Anti-convulsants
Verapamil
Antipsychotics
Patients who respond to lithium virtually be symptom-free over long-term in about how many percent of people treated with lithium respond positive
33%
What is some family education for lithium?
Take medication regularly even one feeling well
Should not drive or operate, dangerous machinery
Do not skimp on dietary sodium and maintain appropriate diet
Carrie identification not taking lithium
Be aware of symptoms of a toxicity
What are the serum lithium levels range
0.6 to 1.2
How often do you have to have serum lithium levels checked?
Every one to two months
Why, Will, a significant increase in dietary sodium intake, reduce the effectiveness of lithium
Sodium will bind at more receptor sites and decrease the amount of lithium that combine to these receptors
How long do you remain on lithium?
Indefinitely
What are the signs and symptoms of lithium toxicity?
Persistent, nausea and vomiting, severe diarrhea, ataxia blurred vision, tinnitus excessive output of urine increased tremors mental confusion
What is some education when taking anticonvulsants?
Refrain from discontinuing drug abruptly, do not drive or operate, dangerous machinery, avoid alcohol and drugs
Parent education for calcium channel blocker
Take medication with meals
Caution while driving or operating machinery
Dizziness, drowsiness, blurred vision can occur
Refrain from discontinuing drug abruptly to do so, may precipitate, cardiovascular problems, 
Really slowly out of bed
Family education for antipsychotics
Use sunblock
Do not discontinue drug abruptly
Right slowly
Continue taking meds, even if feeling well
A client who is prescribed lithium carbonate is being discharged from inpatient care which medication information. Should the nurse teach this client.
Do not skimp on dietary sodium
Have serum lithium levels checked every six months
Limit fluid intake 1000 mL of fluid per day
Adjust the dose if you feel out-of-control
Do not scamp on dietary sodium intake
