Bipolar Disorder Flashcards
Mania
an abnormal and persistent elevated mood/euphoria/elation, expansive mood, lack of restraints in expression, overvalued self-importance, irritable mood
What is mania usually associated with
grandiose behaviors and large egos
Mood lability
rapid mood shifts with little or no change in external events
What is bipolar disorder characterized by
episodes of mania
Bipolar disorder 1
mania or hypomania alternating with depression
How long do symptoms have to be present for to be diagnosed with bipolar disorder 1
Most of the day everyday for at least a week
Nursing assessment for biological domain
changes in activity/sleep/eating/diet/body weight, lab testing of thyroid function, changes in sexual practice, pharmacologic assessment
What is the nursing diagnosis used for
to figure out where to intervene
What medications are often used
antipsychotics (adjunct/monotherapy), antidepressants, mood stabilizers (lithium)
What do physiological and social theories focus on
reducing environmental stress and trauma in genetically vulnerable individuals
What should serum lithium level be maintained at
0.6-1.2
Clinical manifestation of lithium toxicity
nausea, vomiting, diarrhea, tremor, fasciculations, clonus, ataxia, dysarthria, stupor, coma, seizures
Complications of lithium toxicity
neurological changes, dysrhythmias, renal failure
Treatment of lithium toxicity
IV fluids, whole bowel irrigation, hemodialysis
What can impact lithium concentration
excessive fluid, caffeine, salt
What do diuretics and NSAIDs do to lithium
increase lithium reabsorption by the kidneys or inhibit lithium excretion
Biological domain interventions
monitor and manage drugs and side effects, monitor drug interactions, promote adherence, teaching points, psychosocial treatment, somatic treatment, education about physical care
Psychological domain interventions
psychoeducation, individual cognitive behavioral therapy, individual interpersonal therapy, adjunctive therapies, psychotherapy
What is not effective in acute mania
psychotherapy
What should be avoided at the beginning of bipolar treatment
groups
Social domain interventions
protection from self-harm, protection from harm from others, support groups, family interventions, family psychoeducation
Goals of bipolar treatment
minimize and prevent episodes, help patient and family understand and manage disorder
