bipolar disorder (329 E2) Flashcards
risk factor for bipolar disorders
exact cause unknown
-genetic
-neurotransmitters: norepi, dopamine & serotonin
-neurobiological: prefrontal cortical region, hippocampus & amygdala
-neuroendocrine: HPTA axis
-stressful family life
-adverse events
bipolar 1
-most severe form
-highest mortality rate
-at least 1 manic episode
-classically will have a psychotic episode (delusions/hallucinations)
-onset: 18
-more common in males
bipolar 2
-at least 1 hypomanic episode
-at least 1 major depression episode
never has a manic episode
-onset: 20
-more common in females
cyclothymic disorders
-alternate w/ symptoms of mild to moderate depression for at least 2 years (adults)
-rapid cycling possible
-will have hypomanic symptoms and depressive sx but not very extrema
clinical features of mania “dig fast”
distractibility
indiscretion
grandiosity
flight of ideas
activity increase
sleep deficit
talkativeness
behaviors of mania
-mood lability
-quick to anger/feels misunderstood/low frustration tolerance
-pacing
-dramatic mannerisms
-uses jokes
-flamboyant or sexually suggestive dress
-might forget to eat
hypomanic episode
a distinct period of abnormally and persistent elevated expansive or irritable mood and abnormally and persistently increases activity or energy
needs to last at least 4 consecutive days
not severe enough to cause a marked impairment in social or occupational functioning or hospitalization
specifiers for bipolar & related disorders: mixed features
sx of both depression and mania occur at the same time
specifiers for bipolar & related disorders: w/ rapid cycling
four or more manic episodes for at least 2 weeks in 12 months. partial or full remission for 2 months at a time or switch to opposite episode. high risk of recurrence, resistant to drug therapy, greater severity of illness; depressive sx predominate
nursing outcomes when pt is in an acute manic state
primary outcome is injury prevention
pt will:
-be hydrated
-maintain stable cardiac status
-maintain/obtain tissue integrity
-get sufficient sleep and rest
-demonstrate thought self control w/ aid of staff or meds
-make no attempt at self harm
nursing care for acute mania
-manage meds
-decreasing physical activity
-increase food and fluid intake
-ensuring at least 4 to 6 hrs of sleep per night
-intervening so that self care needs are met and setting limits on behavior
what is one way we can prevent hypomania from turning into a full manic episode
getting the patient to sleep
