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Exam 4 > Bipolar disorder > Flashcards

Bipolar disorder Flashcards

1
Q

This disorder is classified as a group of mood disorders with recurrent episodes of depression and mania.

A

Bipolar disorder

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2
Q

Bipolar I consists of…

A

one or more manic/mixed episodes

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3
Q

Bipolar II consists of…

A

one or more major depressive episodes, accompanied by at least one hypomanic episode

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4
Q

This disorder has at least 2 years of repeated hypomanic manifestations that do not meet criteria for hypomanic disorder.

A

Cyclothymic

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5
Q

A patient with cyclothymic disorder may present as being…

A
  • -moody
  • -unpredictable
  • -temperamental
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6
Q

what is rapid cycling?

A

Experience 4 or more episodes of mania/depression in one year.

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7
Q

There are 3 behaviors shown with bipolar disorder. what are they?

A
  • -Mania
  • -hypomania
  • -rapid cycling
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8
Q

What are some RF for bipolar disorder?

A
  • -Typically effects ages 15-30
  • -Genetics (immediate family member)
  • -Physiological (neurobiological, neuroendocrine)
  • -environmental (substance abuse: alcohol, cocaine)
  • -Psychosocial (stressful events, major life changes)
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9
Q

How long does mania typically last?

What age is onset normally seen?

A
  • -1 week

- -early 20’s

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10
Q

what is an abnormal, persistently high, expensive, or irritable mood (euphoria, or agitation)?

A

Mania

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11
Q

To be diagnosed with mania the patient must present with at least manifestations from DSM-5. what are common manifestations in mania?

A
  • -Grandiosity (inflated self esteem)
  • -Reduced need for sleep
  • -Pressure of speech (speak fast)
  • -flight of ideas (topic changes)
  • -distractability
  • -manipulative behavior
  • -unusual appearance
  • -behavior is excessive or “out of bounds”
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12
Q

When a patient is experiencing this type of behavior they feel “on top of the world.”

A

Hypomania

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13
Q

This type of episode may be accompanied by symptoms of mania/hypomania.

A

Depressive episodes

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14
Q

These episodes may be accompanied by symptoms similar to depression.

A

Mania/hypomania episodes

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15
Q

The DSM-5 specifier states a patient must have how many mood episodes in a year to be diagnosed with depressive episodes? They will also have periods of partial/full remission of…

A
  • -4 mood episodes within a year

- -2 months or more

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16
Q

What are mood changes that can be seen in a child with bipolar disorder?

A
  • -irritable

- -hyperactive

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17
Q

What behavior changes may be seen in a child with bipolar disorder?

A
  • -alterations in sleep
  • -talk a lot
  • -racing thoughts
  • -high rate of attempted suicide
18
Q

What are 2 antipsychotic mood stabilizers can be given to a patient with bipolar disorder?

A
  • -Risperidone

- -Olanzapine

19
Q

What are some contraindications with risperidone?

A
  • -Don’t give to dementia patients

- -don’t drink alcohol

20
Q

when a patient is taking risperidone the patient should follow what type of diet?

A

Low calorie and exercise (meds cause weight gain)

21
Q

When taking olanzapine the patient is at increased risk for…

A
  • -diabetes
  • -weight gain
  • -dyslipidemia
22
Q

This med is effective in altering the CNS neurotransmitters and is effective when used long term.

A

Lithium carbonate

23
Q

Lithium carbonate is given orally and takes how many weeks to take effect?

A

1-3 weeks

24
Q

The dose of lithium is increased…

A

gradually until therapeutic effect occurs. (0.8-1.2 mEq/mL

25
Q

In Asians lithium can be toxic at

A

lower levels

26
Q

what blood level indicates toxic symptoms with lithium? The nurse should monitor what labs closely?

A

> 1.5 mEq/L

–Serum levels

27
Q

This type of med can be used in mania therapy.

The nurse must advise the patient not to…

A
  • -Anticonvulsants (valproic acid, lamotrigine, carbamazepine)
  • -Stop abruptly
28
Q

This med helps with bipolar mania. It is quickly injected and calms the patient immediately.

A

atypical antipsychotics

29
Q

what are the hallmark signs of mania?

A
  • -don’t eat/rest
  • -irregular sleep patterns
  • -bruises/other injuries
  • -manic communication
30
Q

what are three nursing diagnosis for Bipolar disorder?

A
  • -Risk for injury
  • -Disturbed thought process
  • -impaired social interaction
  • -sleep deprived
31
Q

When implementing care the nurse should…

A
  • -reduce stimuli
  • -set/enforce limits
  • -promote reality based thinking
  • -establish consistency (set timelines)
  • -clutter free environment
  • -monitor activity
  • -use therapeutic communication
  • -orient them to person, place, time
32
Q

If the patient is having hallucinations or delusions the nurse should…

A
  • -provide therapeutic communication

- -give positive reinforcement when they begin to focus on reality

33
Q

One way to enhance socialization for the patient is to..

A

assign tasks (help improve interactions)

34
Q

the nurse should be sure to set limits by…

A
  • -curbing manipulative behavior

- -establishing consequences for violations of set limits

35
Q

When helping the client with self care the nurse should…

A
  • -monitor I&O’s
  • -offer frequent small snacks
  • -establish toileting schedule
  • -increase fluids, fiber
36
Q

Adequate sleep is important for these clients. The nurse can help promote sleep by…

A
  • -scheduling care around “Sleep-wake cycles”
  • -monitor for signs of fatigue
  • limit naps
  • -prior to bed turn down lights, and noise
  • -allow a sleep cycle of at least 90 min.
  • -increase tasks to promote drowsiness
37
Q

What two levels of bipolar disorder are the most significant?

A

Levels I and II

38
Q

What are most patients diagnosed with first before being diagnosed with bipolar disorder?

A

Depression

39
Q

during the nursing assessment, what should the nurse note?

A

behaviors, changes in thought process, hallucinations, note age

40
Q

When planning care the nurse should…

A
  • -maintain safety
  • -orient them
  • -help them focus on something
  • -encourage them to make choices/maintain self care
  • -no longer experience sleep disturbances
41
Q

How do we know treatment is helping and the clients condition has improved?

A

–Behaviors indicate success

Exam 4 (10 decks)

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