Bipolar and Related Disorders Flashcards
What are the 3 types of disorders?
- Bipolar I
- Bipolar II
- Cylcothmyic Disorder
Which is the most severe type of bipolar disorder?
Bipolar I
Describe Bipolar I
marked by shifts in mood, energy, and ability to fxn may alternate with periods of highs, lows or a combination of both
Define Mania
period of intense mood disturbance with persistent elevation, expansiveness, irritability and extreme goal-directed activity or energy
What occurs as mania intensifies?
individuals become psychotic and experience hallucination, delusions, and dramatically disturbed thought
What occurs after the manic episode?
a major depressive disorder and GAD
Define Bipolar II
individuals who have experiences at least one hypomanic episode
Define hypomania
low-level and less dramatic mania; tends to be euphoric and often increases fxning;
What is the difference between hypomania and mania?
psychosis is never present with hypomania
Define cyclothymic disorder
Sx alt. with Sx of mild-mod depression and some experience rapid cycling
Since men and women have the same occurrence rate, how does each gender differ in their conditions?
Men tend have more legal problems and commit violent acts. Women tend to abuse ETHOL, commit suicide and develop thyroid disease
What conditions are associated with bipolar I ?
- Anxiety disorders
- ADHD, substance abuse, impulse-control or conduct disorders
- migraines
- high blood glucose
- apple shape
- abnormal cholesterol levels
- CVD diseases
What conditions are associated with bipolar II?
- Anxiety disorders
- Eating disorders
- Substance use
What is the concordance rate in identical twins?
70%
Which neurotransmitters contribute to Bipolar?
- NE
- Dopamine
- Serotonin
What is an envtl factor?
Stress
What is the mania mood like?
they experience intense feelings of well-being.
- they may laugh, joke, and talk in a continuous stream with uninhibited familiarity
- mood may change quickly to irritation and anger if someone get in their way
What is the mania behavior like?
they have an appetite for social engagement, spending, and activity and indiscriminate sex
What is the hallmark Sx of mania?
Distractibility; they lose their focus and go from one activity or place to another
What are some thought processes and speech patterns?
- pressured speech
- circumstantial speech
- Tangential speech
- Loose associations
- Flight of ideas
- Clang associations
What are some nursing Dx?
- Altered though processes
- Impaired social interaction
- Sleep deprivation
- Risk for injury
- Risk for other- directed violence
What is the nurse role during the manic phase?
- manage meds
- decrease physical activity
- increase food and fluids
- ensuring 4-6 hrs/night of sleep
What are the types of meds are given during agitation?
Severe- Li+ or Depakote (valproate) olanzapine or risperdone
Short-term- Klonopin and Ativan
What is the one true mood stabilizer?
Li+
When are anticonvulsants used for maintaining acute mania and bipolar?
- No fam history
- Diminishing impulsive and aggressive behavior in nonpsychotic pt
- ETHOL and benzodiazepine withdrawal
- Controlling mania w/in 2 week and depress w/in 3 wks
What is ECT?
Electroconvulsive therapy
What is the purpose of ECT in bipolar disorder?
subdue severe manic behavior especially in pts w/ treatment-resistant mania and pts with rapid cycling
When a pt is dangerously out of control, what is a nursing intervention?
place the pt in seclusion or place restraints
Treatment of bipolar with a common antidepressant alone increases or decreases the risk of bringing on a manic episode?
increases
Which 2 antidepressants are indicated for bipolar depression?
lurasidone (Latuda)
quetiapine (Seroquel)
What is a communication technique when speaking with a pt w/ bipolar?
set limits in a firm, neutral manner and tailor communication techniques
During the manic phase, which needs often take the priority?
physical needs
