Bipolar Flashcards
What is bipolar?
Once commonly known as manic-depression, bipolar disorder is a chronic, recurrent illness that must be carefully managed throughout a person’s life.
What are characteristics of mania?
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.
Bipolar 1 disorder?
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
What are the behaviors that constitute mania?
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
What are the two types of mania?
Euphoric mania and dysphoric mania
Euphoric mania
Feels wonderful in the beginning, but it turns scary and dark as it progresses toward loss of control and confusion.
Dysphoric mania
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
What is Bipolar level 2
Low-level mania alternates with profound depression. hypomania
Hypomania
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.
Does Bipolar level 2 cause severe social impairments?
Not usually severe enough to cause serious impairment. However, depressive symptoms tend to put those who suffer from it at particular risk for suicide.
What is Cyclothymic disorder?
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.
Can you give antidepressants to bipolar pts?
No! It kicks them in mania.
Who is bipolar 1 more common in?
Males
Who is bipolar 2 more common in?
Females
Flight of ideas?
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.
What is clang association?
Are the stringing together of words because of their rhyming sounds, without regard to their meaning
What is grandiosity?
Is apparent in both the ideas expressed and the person’s behavior. People with mania may exaggerate their achievements or importance.
Acute phase?
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
Continuation phase?
last for 4 to 9 months
Overall outcome is relapse prevention
Maintenance Phase?
Continue to focus on prevention of relapse and limitation of the severity and duration of future episodes.
Acute phase planning?
Medical stabilization
Maintaining safety
Self-care needs
Continuation phase planning?
Maintain medication adherence
Psychoeducational teaching
Referrals
What drug is best for bipolar?
Lithium carbonate
What is the Lithium carbonate therapeutic levels?
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
What are SE of Lithium?
Tremors
GI
What are some long-term effects of lithium?
- Hypernatremia
* Hypothyroidism
What are the 3 anti convulsive drugs?
Valproate
Carbamazepine
Lamotrigine
What are important factors of Valproate?
Sedating
Weight gain
What are important factors o Lamotrigine
Can cause Steven Johnson syndrome
What are the main anxiety drugs?
Clonazepam (Klonopin)
Lorazepam (Ativan)
Atypical antipsychotics
Olanzapine (Zyprexa)
Atypical antipsychotics
Have sedative properties along with mood-stabilizing properties
What is Cognitive-behavioral therapy (CBT)?
involves identify maladaptive cognitions and behaviors that may be barriers to a persons revoer and ongoing mood stability.
Interpersonal and social rhythm therapy?
This therapy addresses the variables that relate to recurrence of symptoms, especially non adherence with medication, stress management, and maintenance of social supports.
A medication teaching plan for a pt receiving lithium should include:
Periodic monitoring of renal and thyroid functions.
