Bipolar

Question 1

What is bipolar?

Answer 1

Once commonly known as manic-depression, bipolar disorder is a chronic, recurrent illness that must be carefully managed throughout a person’s life.

Question 2

What are characteristics of mania?

Answer 2

Are the happiest, most excited, and most optimistic people you could meet. They feel euphoric and energized; they don’t sleep or eat, and they take constantly.

Question 3

Bipolar 1 disorder?

Answer 3

Characterized by at least one week-long manic episode that results in excessive activity and energy. 
The presence of three s/s. 
May have psychotic features. 
Hospitalized 
Suicidal/homicidal 
Not going to have as severe depression 
Always worry about safety 
Seclusion or restraint 
Safety, nutrition, self-care
Nurse: Never play favorite, thick skin, firm, consistent, distraction can be used

Question 4

What are the behaviors that constitute mania?

Answer 4

Extreme drive and energy.
Inflated sense of self-importance
Drastically reduced sleep requirements
Excessive talking combined with pressured speech
Personal feeling of racing thoughts
Distraction by environmental events
Unusually obsessed with and over focused on goals
Purposeless arousal and movement
Dangerous activités such as indiscriminate spending, reckless sexual encounters, or risky investments

Question 5

What are the two types of mania?

Answer 5

Euphoric mania and dysphoric mania

Question 6

Euphoric mania

Answer 6

Feels wonderful in the beginning, but it turns scary and dark as it progresses toward loss of control and confusion.

Question 7

Dysphoric mania

Answer 7

Also referred to as a mixed state or agitated depression, with depressive symptoms alone with mania. \
May be irritable, suicidal, or hyper sexual and may experience pain attacks, pressured speech, agitation, severe insomnia or grandiosity as well as persecutory delusions and confusion

Question 8

What is Bipolar level 2

Answer 8

Low-level mania alternates with profound depression. hypomania

Question 9

Hypomania

Answer 9

Tends to be euphoric and often increases functioning. Is accompanied by excessive activity and energy for at least four days and involves at least three of the behaviors listed under mania.

Question 10

Does Bipolar level 2 cause severe social impairments?

Answer 10

Not usually severe enough to cause serious impairment. However, depressive symptoms tend to put those who suffer from it at particular risk for suicide.

Question 11

What is Cyclothymic disorder?

Answer 11

Symptoms of hypomania alternate with symptoms of mild to moderate depression for at least two years in adults and one year in children. Some may experience rapid cycling.

Question 12

Can you give antidepressants to bipolar pts?

Answer 12

No! It kicks them in mania.

Question 13

Who is bipolar 1 more common in?

Answer 13

Males

Question 14

Who is bipolar 2 more common in?

Answer 14

Females

Question 15

Flight of ideas?

Answer 15

Is nearly continuous flow of accelerated speech with abrupt changes from topic to topic that are usually based on understandable associations or plays on words.

Question 16

What is clang association?

Answer 16

Are the stringing together of words because of their rhyming sounds, without regard to their meaning

Question 17

What is grandiosity?

Answer 17

Is apparent in both the ideas expressed and the person’s behavior. People with mania may exaggerate their achievements or importance.

Question 18

Acute phase?

Answer 18

Injury prevention. 
Be well hydrated
maintain stable cardia status 
maintain/obtain tissue integrity 
Get sufficient sleep and rest
Demonstrate thought self-control 
Make no attempt at self-harm

Question 19

Continuation phase?

Answer 19

last for 4 to 9 months

Overall outcome is relapse prevention

Question 20

Maintenance Phase?

Answer 20

Continue to focus on prevention of relapse and limitation of the severity and duration of future episodes.

Question 21

Acute phase planning?

Answer 21

Medical stabilization
Maintaining safety
Self-care needs

Question 22

Continuation phase planning?

Answer 22

Maintain medication adherence
Psychoeducational teaching
Referrals

Question 23

What drug is best for bipolar?

Answer 23

Lithium carbonate

Question 24

What is the Lithium carbonate therapeutic levels?

Answer 24

Therapeutic blood level: 0.8 to 1.4 mEq/L
Maintenance blood level: 0.4 to 1.3 mEq/L
Toxic blood level: 1.5 mEq/L and above

Question 25

What are SE of Lithium?

Answer 25

Tremors

GI

Question 26

What are some long-term effects of lithium?

Answer 26

• Hypernatremia

* Hypothyroidism

Question 27

What are the 3 anti convulsive drugs?

Answer 27

Valproate
Carbamazepine
Lamotrigine

Question 28

What are important factors of Valproate?

Answer 28

Sedating

Weight gain

Question 29

What are important factors o Lamotrigine

Answer 29

Can cause Steven Johnson syndrome

Question 30

What are the main anxiety drugs?

Answer 30

Clonazepam (Klonopin)
Lorazepam (Ativan)
Atypical antipsychotics
Olanzapine (Zyprexa)

Question 31

Atypical antipsychotics

Answer 31

Have sedative properties along with mood-stabilizing properties

Question 32

What is Cognitive-behavioral therapy (CBT)?

Answer 32

involves identify maladaptive cognitions and behaviors that may be barriers to a persons revoer and ongoing mood stability.

Question 33

Interpersonal and social rhythm therapy?

Answer 33

This therapy addresses the variables that relate to recurrence of symptoms, especially non adherence with medication, stress management, and maintenance of social supports.

Question 34

A medication teaching plan for a pt receiving lithium should include:

Answer 34

Periodic monitoring of renal and thyroid functions.