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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?

24
Q

The dose of lithium is increased…

A

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

25
In Asians lithium can be toxic at
lower levels
26
what blood level indicates toxic symptoms with lithium? The nurse should monitor what labs closely?
>1.5 mEq/L | --Serum levels
27
This type of med can be used in mania therapy. | The nurse must advise the patient not to...
- -Anticonvulsants (valproic acid, lamotrigine, carbamazepine) - -Stop abruptly
28
This med helps with bipolar mania. It is quickly injected and calms the patient immediately.
atypical antipsychotics
29
what are the hallmark signs of mania?
- -don't eat/rest - -irregular sleep patterns - -bruises/other injuries - -manic communication
30
what are three nursing diagnosis for Bipolar disorder?
- -Risk for injury - -Disturbed thought process - -impaired social interaction - -sleep deprived
31
When implementing care the nurse should...
- -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
If the patient is having hallucinations or delusions the nurse should...
- -provide therapeutic communication | - -give positive reinforcement when they begin to focus on reality
33
One way to enhance socialization for the patient is to..
assign tasks (help improve interactions)
34
the nurse should be sure to set limits by...
- -curbing manipulative behavior | - -establishing consequences for violations of set limits
35
When helping the client with self care the nurse should...
- -monitor I&O's - -offer frequent small snacks - -establish toileting schedule - -increase fluids, fiber
36
Adequate sleep is important for these clients. The nurse can help promote sleep by...
- -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
What two levels of bipolar disorder are the most significant?
Levels I and II
38
What are most patients diagnosed with first before being diagnosed with bipolar disorder?
Depression
39
during the nursing assessment, what should the nurse note?
behaviors, changes in thought process, hallucinations, note age
40
When planning care the nurse should...
- -maintain safety - -orient them - -help them focus on something - -encourage them to make choices/maintain self care - -no longer experience sleep disturbances
41
How do we know treatment is helping and the clients condition has improved?
--Behaviors indicate success

Exam 4 (10 decks)

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