Bipolar Disorder & meds Flashcards
What term is used to describe clouding of consciousness occurs?
Delirious mania
Paranoid & grandiose delusions are common in?
manic episodes
Recurrent bouts of major depression w/ episodes of hypomania is?
Bipolar II disorder
What term is characterized by mood swings b/t hypomania & mild depression?
Cyclothymic disorder
Excessive interest in sexual activity is common in?
Manic episodes
Recurret bouts of mania w/ episodes of depression is?
Bipolar I disorder
Frenzied motor activity characterized by agitated, purposelless movements is?
Delirious mania
What is the term used to describe alteration in mood w/ feelings of elation, inflated self-esteem, grandiosity, hyperactivity, agitation, & accelerated thinking & speaking?
Mania
What is the term used to describe alteration in mood w/ feelings of loss of pleasure in usual activities, sad affect, decreased concentration, fatigue, changes in sleep/appetite, decreased social interactions, psychomotor retardation, & suicidal thoughts?
Major depression
What disorder is more common in males, has excess dopamine & norepinephrine & fluctuates b/t baseline mood, mania & major depression, pt. can’t sleep, splits staff & is euphoria in manic episodes?
Bipolar disorder, type I
What is the term used to describe milder form of mania?
Hypomania
What disorder is more common in females, is common to be misdiagnosed/missed, is associated w/ hypomania & major depression, never experiences a full manic episode & fluctuates b/t baseline mood, hypomania & maj. depression?
Bipolar disorder, type II
What disorder can be rapidly changing w/in sec/mins. is a stigmatize bipolar & include symptoms like: rapidly alternating moods (sadness, irritability, euphoria) & accompanied by symptoms associated w/ both depression & mania. Fluctuates b/t baseline, hypomania, maj. depression, mania, minor depression?
Mixed Bipolar disorder
What disorder is a chronic mood disorder that is never w/o symptoms for more than 2 mon. w/ a duration of at least 2years & includes numerous episodes of hypomania & minor depression of insufficient severity to meet criteria for either bipolar I or II or MDD?
Cyclothymic Disorder
A suicidal pt, w/ history of manic behavior is admitted to the ED. The pt’s diagnosis is documented as bipolar I disorder: depressive state. What’s the rationale for this diagnosis vs. a diagnosis of major depression?
A. Physician doesn’t believe the pt. is suffering from maj. depression
B. The pt has experienced a manic episode in the past
C. The pt doesn’t exhibit psychotic symptoms
D. There’s no history of major depression in the pt’s family
B. The pt has experienced a manic episode in the past
What does FIND stand for to diagnose bipolar in children/adolescence?
Frequency symptoms occur most days in wk
Intensity symptoms severe enough to cause extreme disturbance
Number symptoms occur 3-4 times/day
Duration symptoms occur 4 or more hours a day
These symptoms are associated w/ what disorder: euphoric/irritable mood, grandiosity, decreased need for sleep, pressured speech, racing thoughts, distractibility, psychomotor agitation in goal directed activities, risky behaviors, psychosis,suicidal thoughts?
Childhood & adolescence Bipolar symptoms
In the initial stages of caring for a pt. experiencing an acute manic episode, what should the nurse consider to be the priority nursing diagnosis?
A. Risk for injury r/t excessive hyperactivity
B. Disturbed sleep pattern r/t manic hyperactivity
C. Imbalanced nutrition: less than body requires r/t inadequate intake
D. Situational low self-esteem r/t embarrassment secondary to high risk behaviors
A. Risk for injury r/t excessive hyperactivity
What medications do bipolar pt’s never get?
Antidepressants
What medications are used for mania in bipolar disorder for mood stabilizing?
Antimanic, anticonvulsants, antipsychotics
What medication is used for the depressive phase of bipolar disorder?
Antimanic- Lithium
Why should pt’s w/ bipolar disorder not receive antidepressants?
Bc may trigger mania
This med may modulate norepinephrine, serotonin, dopamine, glutamate & GABA?
Lithium
Lithium is also known as what?
Salt
What two systems are involved in salt?
Renal & cardiac
Lithium can interfere w/ what by a lot, so maintaining this & water intake is very important?
Sodium/potassium levels
What are therapeutic lithium ranges?
0.6-1.2mEq/L
A lithium level of >1.5 is what?
Lithium toxicity
A lithium level of >2.5 is what?
Lethal
What are therapeutic ranges of lithium for acute mania?
1.0-1.5mEq/L
How long should blood be drawn 1st if a pt. is on lithium in order to start getting it drawn monthly if it is stable then 3 months if it remains stable?
1-2xs/wk
These side effects are associated with which med: dry mouth, thirst, GI upset, N/V, drowsiness, dizziness, headache, fine hand tremors, hypotension, arrhythmias, pulse irregularities, polyuria, dehydration, weight gain, & potential for toxicity?
Lithium
What should you monitor for if a pt. is on lithium?
I&O, electrolyte levels, weight
These medications: Valproic acid (Depakote), Lamotrigine (Lamictal), Carbamazepine (Tegretol) or Tiliptal are what medications & used as what in the depressive phase of bipolar disorder?
Anticonvulsants; mood stabilizers
These side effects are associated w/ which medication: N/V, drowsiness, dizziness, blood dyscrasia, risk of suicide?
Anticonvulsants
Which med has a side effect of prolonged bleeding time?
Depakote
Which med has a side effect of risk for severe rash (Steven’s Johnson)?
Lamictal
These medications: Olanzapine (Zyprexa), Quetiapine (Seroquil), Risperidone (Risperdal), Aripirazole (Abilify), Chlorpromazine (Thorazine), Ziprasidone (Geodon) or Asenaphine (Saphris) are what kind of medications and used for what in the depressive phase of bipolar disorder?
Antipsychotic; mood/aggression
Antipsychotics should be used in conjunction w/?
Anticonvulsants
These side effects are associated with which medication: Drowsiness, dizziness, dry mouth, constipation, increased appetite, weight gain, ECG changes, EPS, hyperglycemia & diabetes?
Antipsychotics
Atypical antipsychotics should be watched out for what?
Metabolic syndrome & elevated blood sugar & cholesterol
A pt who is prescribed lithium carbonate is being discharged from inpt. care. Which med info should the nurse teach the pt?
A. Do not skimp on dietary sodium intake
B. Have serum lithium levels checked q6mon.
C. Limit fluid intake to 1000ml of fluid per day
D. Adjust the dose if you feel out of control
A. Do not skimp on dietary sodium intake
How long does ECT last?
20 seconds
How often is ECT administered?
every other day, 6-12 times up to 3-4 wks
ECT is used for patients w/ what?
Bipolar/schizo if in manic phase
Cardiovascular/pulmonary state, skeletal osteoporosis, mood/teeth, VS, orientation & explaining what happened is?
Assessments after ECT
Elevated intracranial pressure, or if a pt. had a stroke w/in 3 months are?
contraindications for ECT
A pt.’s norepinephrine, serotonin & dopamine levels w/ bipolar disorder are?
Deficient/low
Accelerated & pressured speech is common in?
Manic episodes
