Bipolar

Question 1

bipolar disorder is characterized by

Answer 1

dramatic fluctuation in mood - highs to lows

life-long disorder - meds for whole life

Question 2

2 types of bipolar disorder

Answer 2

I and II

Question 3

bipolar I

Answer 3

major depression and mania

Question 4

bipolar II

Answer 4

hypo-mania with depression

Question 5

which bipolar do you see psychosis

Answer 5

bipolar I

Question 6

mood s/s of bipolar

Answer 6

acute mania (exaggerated euphoria) then becomes agitated especially if kept from something they want
not completing tasks - going from one to the other

Question 7

physical s/s of bipolar

Answer 7

non-stop activity to the point of not eating

Question 8

cognitive s/s of bipolar

Answer 8

interfering with occupational (poor concentration/judgment) difficulty remembering

Question 9

behavioral s/s of bipolar

Answer 9

hyperactivity, impulsive

Question 10

altered thought process r/t bipolar

Answer 10

disorganization of speech (sexually explicit lang)
flight of ideas
delusion (false fixed belief) - grandiose
clanging

Question 11

phases of mania

Answer 11

acute phase - overdosed, trouble after risky behavior
continuation phase - after discharge to prevent relapse
maintenance phase - preventing relapse

Question 12

important intervention for bipolar

Answer 12

safety (self and others are safe)

taking care of themselves (eat, sleep)

Question 13

assess this with bipolar

Answer 13

mental status (abct - appearance, behavior, cognition, thought process)
depressive symptoms
risk to hurt someone else or themselves
risky behaviors
medical status - are they eating drinking (dehydration)
high prevalence of comorbidities
how much do they understand about their disorder

Question 14

what is a rapid cycler

Answer 14

4 or more mood episodes in a 12 month period

Question 15

A nurse prepares the plan of care for a patient having a
manic episode. Which nursing diagnoses are most
likely? Select all that apply.

Answer 15

B.Disturbed thought processes

C.Sleep deprivation

Question 16

**outcomes based on phase

Answer 16

individual going to groups
dressing appropriately for season
eating balanced
sleeping well

Question 17

Outcome identification for the treatment plan of a
patient with grandiose thinking associated with acute
mania focuses on:

Answer 17

B.self-control of distorted thinking

Question 18

**nurs dx priority for bipolar

Answer 18

dangerousness is 1st (high risk for injuring self or others)

meeting basic needs (food, sleep, hygiene, elimination)

Question 19

communication for those with bipolar

Answer 19

firm and calm
decrease environmental stimuli
be consistent (try to pit staff against each other) - set boundaries

Question 20

drug used for acute mania

Answer 20

lithium

Question 21

drugs (2) for rapid cycling

Answer 21

depakote, tegratol

Question 22

in acute mania use least restrictive environment 1st, then

Answer 22

chemical restraint, if necessary seclusion or restraints (last resort) - must have documentation to support use

Question 23

interventions for acute mania

Answer 23

provide safe environment - decreased stimulation
promote adequate nutrition - give finger foods (wont eat meal)
matter-of-fact approach - i need you to…not to do…
maintain professionalism
simple tasks that they can focus on and feel good about themselves
draw on their strengths - identify realistic goals

Question 24

A patient with acute mania has disrobed in the hall three times in 2 hours. The nurse should:

Answer 24

D.arrange for one-on-one supervision

Question 25

ect can be used for mania, when would you use it

Answer 25

no meds have used, they’re a rapid cycler

Question 26

evaluation of trt for bipolar

Answer 26

make sure they aren’t suicidal or homicidal - can they state alternatives
taking meds
are they having healthy relationships

Question 27

Mr. Quang is dancing under the overhead television of the crisis stabilization unit and taunting the other patients in the room. He shouts, “I own the TV networks, so they have to do what I say!” As Mr. Quang’s nurse, what is your best initial intervention at this time?

Answer 27

D.Calmly motion for Mr. Quang to come with you to the

dining room for a snack.