Bipolar Disorder

Question 1

pervasive and sustained emotion

Answer 1

mood

Question 2

emotional reaction associated with an experience

Answer 2

affect

Question 3

alterations in mood associated with mania

Answer 3

Elation
Inflated self-esteem
Grandiosity
Hyperactivity
Agitation
Racing thoughts
Accelerated speech

Question 4

appr ___ million american adult are affect by bipolar disorder

Answer 4

5.7

Question 5

average onset age of bipolar disorder

Answer 5

early 20s

Question 6

bipolar is more common in ___

Answer 6

single people
higher socioeconomic classes

Question 7

bipolar disorder is the ___ leading cause of disability in middle age

Answer 7

6th

Question 8

what is bipolar disorder?

Answer 8

-Characterized by mood swings from profound depression to extreme euphoria/mania
-Intervening periods of stable mood!!!
-Delusions or hallucinations possible - severe ends of spectrum
-Onset of symptoms may reflect seasonal pattern (light)
-Hypomania - mild mania - able to function

Question 9

what is catatonic?

Answer 9

sever immobility
may not eat or drink (malnutrition)

Question 10

characteristics for bipolar I disorder

Answer 10

Full syndrome of manic or mixed symptoms
Possible episodes of depression
Psychotic (delusions) or catatonic (severe immobility) features possible
covers the entire mood spectrum

Question 11

characteristics for bipolar II disorder

Answer 11

Major depression with episodic occurrence of hypomania
Never met criteria for full manic episode

Question 12

characteristics for cyclothymic disorder

Answer 12

Chronic mood disturbance
At least 2-years
Numerous episodes of hypomania and depressed mood

Question 13

Direct result of the physiological effects of a substance

Answer 13

substance-induced bipolar disorder

Question 14

Abnormally and persistently elevated, expansive, or irritable mood and excessive activity or energy

Answer 14

bipolar disorder associated with another medical condition

Question 15

genetic factors and stats for bipolar disorder

Answer 15

Concordance rate for bipolar disorder among monozygotic twins at 60-80%
Compared to 10-20% in dizygotic twins
If one parent has a mood disorder, risk that a child will have a mood disorder is between 10-25%
Biochemical influences

Question 16

bipolar disorder shows what neuroanatomical dysfunction:

Answer 16

Prefrontal cortex - impulse control, rational thought, decision making
basal ganglia -
temporal and frontal lobes of forebrain
parts of limbic system - emotional brain

Question 17

bipolar medication side effects

Answer 17

Steroids frequently used to treat multiple sclerosis and systemic lupus erythematosus
Amphetamines (stimulants), antidepressants, and high doses of anticonvulsants and narcotics

Question 18

Bipolar disorder results from an interaction between genetic, biological and psychosocial determinants

Answer 18

transactional model of stress and adaption

Question 19

atypical symptoms for children with dipolar disorder

Answer 19

non-discrete mood episodes
chronic irritability
temper tantrums

very hard to diagnose

Question 20

treatment strategies for bipolar disorder in children

Answer 20

psychopharmacology

Question 21

most common comorbid condition in childhood

Answer 21

ADHD - may exacerbate mania

Question 22

family interventions

Answer 22

psychoeducation
communication training
problem-solving skills training

Question 23

how does gender affect diagnosis of bipolar

Answer 23

roughly equal

Question 24

nursing process/assessment of stage I hypomania

Answer 24

MILD
Cheerful mood
Rapid flow of ideas
Heightened perception
Increased motor activity

Question 25

nursing process/assessment for stage II acute mania

Answer 25

EXACERBATION Elation and euphoria Continuous “high” Flight of ideas Accelerated, pressured speech Hallucinations and delusions Excessive motor activity Social and sexual inhibition Little need for sleep

Question 26

nursing process/assessment stage III delirious mania

Answer 26

Labile (unstable) mood; panic anxiety Clouding of consciousness Disorientation Frenzied psychomotor activity Exhaustion and possibly death without intervention

Question 27

nursing process for nursing diagnosis: risk for violence

Answer 27

-Remove all dangerous objects from the environment -Maintain a calm attitude -If restraint is deemed necessary, ensure that sufficient staff is available to assist -Goals and interventions

Question 28

nursing process for nursing diagnosis:: impaired social interaction

Answer 28

-Set limits on manipulative behaviors -Do not argue, bargain, or try to reason with the client -Provide positive reinforcement -Goals and interventions

Question 29

planning portion of nursing diagnosis for bipolar disorder

Answer 29

The client: Exhibits no evidence of physical injury Has not harmed self or others Is no longer exhibiting signs of physical agitation Eats a well-balanced diet with snacks to prevent weight loss and maintain nutritional status Verbalizes an accurate interpretation of the environment

Question 30

evaluation of care for manic episodes

Answer 30

Has the individual avoided personal injury? Has violence to client or others been prevented? Has agitation subsided? Have nutritional status and weight been stabilized Have delusions and hallucinations ceased? Is the client able to make decisions about own self-care?

Question 31

treatment modalities for manic episodes

Answer 31

Individual psychotherapy Group therapy Family therapy Cognitive therapy

Question 32

ECT is used as occasional treatment for ___

Answer 32

episodes of acute mania

Question 33

why would ECT be used for acute mania treatment

Answer 33

When client does not tolerate lithium or other drug treatment When life is threatened by dangerous behavior or exhaustion

Question 34

medications for mania

Answer 34

Lithium carbonate Anticonvulsants Antipsychotics

Question 35

medications for depressive phase of bipolar disorder

Answer 35

Use antidepressants with CAUTION Could activate mania

Question 36

factors for recovery model for bipolar disorders

Answer 36

Exhibiting self-awareness Becoming an expert on the disorder Taking medications regularly Recognizing earliest symptoms Identifying and reducing sources of stress Knowing when to seek help Developing a personal support system Managing lifestyle factors such as sleep time and exercise Developing a plan for emergencies