Bipolar Disorders

Question 1

When do bipolar disorders typically emerge?

Answer 1

Early adulthood

Question 2

Expected findings of Bipolar disorders can mimic what disorders (three)

Answer 2

ADHD, depression, anxiety

Question 3

A patient who was previously diagnosed with bipolar II disorder gets hospitalized for a manic episode. What does this automatically classify as?

Answer 3

Bipolar I Disorder

Question 4

Cyclothymia is defined as…

Answer 4

At least two years of related hypomanic manifestation that do not meet criteria for hypomania alternating with minor depression.

Question 5

A patient is admitted to the inpatient psychiatric unit for mania, what behavior do you expect?

Answer 5

Elevated mood - expansive, irritable
Inflated self-esteem
Lack of insight
Rapid speech
Disorganized thoughts
Promiscuity

Question 6

What is rapid cycling?

Answer 6

Four or more episodes of mania or hypomania within one year

Question 7

What type of therapy may be used to treat mania if medications are ineffective?

Answer 7

Electroconvulsive therapy (ECT)

Question 8

A patient with bipolar disorder is being discharged from the inpatient unit after being prescribed lithium, what teaching should you as the nurse provide?

Answer 8

Maintain regular salt intake
Consume 2-3L of fluid
S/s of toxicity
Hand tremors may be exacerbated by stress or caffeine
This is a life-long treatment
Weight gain is common
Follow-up for regular labs

Question 9

What serum level is optimal for lithium and what are the s/s of lithium toxicity?

Answer 9

1.0-1.5; Mental confusion, sedation, coarse tremors, nausea, vomiting, diarrhea, poor coordination

Question 10

What type of medication increases Na excretion and may lead to lithium toxicity?

Answer 10

Diuretics

Question 11

You overhear a patient in the inpatient psychiatric facility with bipolar I disorder stating, “I feel so much better, I can’t wait to get off my medication and go home.” What teaching would you provide to this patient?

Answer 11

Bipolar disorder typically requires life-long pharmacological and psychological support.

Question 12

What techniques would you use to communicate with a patient diagnosed with a bipolar disorder?

Answer 12

Be calm, direct, specific
Concise explanations
Provide consistency and boundaries
Avoid power struggles

Question 13

What kind of food options should you provide to a patient in a manic state?

Answer 13

Finger foods that are easy to take on the go.

Question 14

What are the expected findings of a patient in a depressive episode of bipolar disorder?

Answer 14

Flat, blunted affect
Anhedonia
Physical pain/discomfort
Psychomotor retardation or agitation

Question 15

What can cause a relapse of mania?

Answer 15

Use of substances
Sleep disturbances
Psychological stressors

Question 16

What is the standardized screening tool for bipolar disorder?

Answer 16

Mood disorders questionnaire

Question 17

Name three comorbidities often seen with bipolar disorders.

Answer 17

SUD, Anxiety, ADHD, Migraines, Borderline personality disorder…

Question 18

This phase of client care has a primary goal of relapse prevention through education, medication adherence, and psychotherapy.

Answer 18

Continuation Phase

Question 19

Bipolar disorders are defined as…

Answer 19

Mood disorders with recurrent episodes of depression and mania or hypomania.

Question 20

Antiepileptics are commonly used to treat and prevent manic episodes by potentiating what?

Answer 20

GABA