Bipolar Flashcards
bipolar disorder is characterized by
dramatic fluctuation in mood - highs to lows
life-long disorder - meds for whole life
2 types of bipolar disorder
I and II
bipolar I
major depression and mania
bipolar II
hypo-mania with depression
which bipolar do you see psychosis
bipolar I
mood s/s of bipolar
acute mania (exaggerated euphoria) then becomes agitated especially if kept from something they want not completing tasks - going from one to the other
physical s/s of bipolar
non-stop activity to the point of not eating
cognitive s/s of bipolar
interfering with occupational (poor concentration/judgment) difficulty remembering
behavioral s/s of bipolar
hyperactivity, impulsive
altered thought process r/t bipolar
disorganization of speech (sexually explicit lang)
flight of ideas
delusion (false fixed belief) - grandiose
clanging
phases of mania
acute phase - overdosed, trouble after risky behavior
continuation phase - after discharge to prevent relapse
maintenance phase - preventing relapse
important intervention for bipolar
safety (self and others are safe)
taking care of themselves (eat, sleep)
assess this with bipolar
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
what is a rapid cycler
4 or more mood episodes in a 12 month period
A nurse prepares the plan of care for a patient having a
manic episode. Which nursing diagnoses are most
likely? Select all that apply.
B.Disturbed thought processes
C.Sleep deprivation
**outcomes based on phase
individual going to groups
dressing appropriately for season
eating balanced
sleeping well
Outcome identification for the treatment plan of a
patient with grandiose thinking associated with acute
mania focuses on:
B.self-control of distorted thinking
**nurs dx priority for bipolar
dangerousness is 1st (high risk for injuring self or others)
meeting basic needs (food, sleep, hygiene, elimination)
communication for those with bipolar
firm and calm
decrease environmental stimuli
be consistent (try to pit staff against each other) - set boundaries
drug used for acute mania
lithium
drugs (2) for rapid cycling
depakote, tegratol
in acute mania use least restrictive environment 1st, then
chemical restraint, if necessary seclusion or restraints (last resort) - must have documentation to support use
interventions for acute mania
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
A patient with acute mania has disrobed in the hall three times in 2 hours. The nurse should:
D.arrange for one-on-one supervision
ect can be used for mania, when would you use it
no meds have used, they’re a rapid cycler
evaluation of trt for bipolar
make sure they aren’t suicidal or homicidal - can they state alternatives
taking meds
are they having healthy relationships
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?
D.Calmly motion for Mr. Quang to come with you to the
dining room for a snack.
