Bipolar, Schizophrenia,Gender Flashcards
Why does it hard to diagnose bipolar in children?
Because manifestations can mimic ADHD
What is Mania?
Symptoms?
Found in Bipolar I
M More energy
A Agitation
N Non-stop talking
I Insomnia and Impulsivity
A Attention
Depressive symptoms
Flat
Blunted 鈍い
Tearfulness
Lack of energy
Anhedonia
Bipolar I Disorder
At least one full manic episode
at least for a week
Bipolar 2 Disorder
At least one episode of hypomania
Persist for at least four days,
One major depressive episode
Never has a full manic episode
Cyclothymic disorder
A milder form of bipolar disorder
Many “mood swings,” with hypomania and depressive symptoms that occur frequently
Bipolar disorder
Rapid cycle
Four or more mood episodes within 12 months
Priority nursing intervention
Bipolar I: Mania 5
Safety and maintaining physical health!!
-Decrease stimulation
-Assess regularly for suicidal thoughts
-High-calorie food and adequate fluid intake
-Promote adequate sleep
-Provide for physical activity
Baseline bloodwork
Valproate or Valproic acid 3
CBC (Complete blood count)
Liver function tests
Menstrual cycle history
Baseline bloodwork
Lithium 5
Thyroid Functions test
CBC
Electrolytes (lithium=sodium)
Pregnancy test
Renal function
lithium toxicity
For acute mania?
For maintenance?
For acute mania: 1.0-1.5
For maintenance: 0.6-1.2
lithium toxicity
Must report! 4
-Extreme thirst
-Excessive urination
-Vomiting and diarrhea
-Tremors
lithium
These are just side effects 4
No report!
-dry mouth
-thirst
-drowsiness
-weight gain
Risk for lithium toxicity
Pt has a____________ and b_______________.
DO NOT administer who is under a_______ or b___________.
Do not take with e_______take f_______ instead
a) Renal failure
Creatinine over 1.3 means BAD kidney
b) Elderly patients
c) dehydration
d) hyponatremia (less than 135)
e) NSAIDs like ibuprofen
f) Tylenol
What is Anhedonia?
Loos of pleasure and lack of interest in activities, hobbies and sexual activity
In the initial stages of caring for a client experiencing an acute manic episode, what should the nurse consider to be the priority
nursing diagnosis?
a. Risk for injury related to excessive hyperactivity
b. Disturbed sleep pattern related to manic hyperactivity
c. Imbalanced nutrition, less than body requirements, related to
inadequate intake
d. Situational low self-esteem related to embarrassment secondary to
high-risk behaviors
A
maintaining client safety is always a priority
Factors that place a patient at risk for lithium toxicity.
Therapeutic window is narrow
For acute mania: 1.0 to 1.5 mEq/L
For maintenance: 0.6-1.2 mEq/L
A nurse is discussing relapse prevention with a client who has bipolar disorder. Which of the following information should the nurse include in the teaching? (select all that apply)
a) Use caffeine in moderation to prevent relapse
b) Difficulty sleeping can indicate a relapse
c) Begin taking your medications as soon as a relapse begins
d) Participating in psychotherapy can help prevent a relapse
e) Anhedonia is a clinical manifestation of a depressive relapse
b,d,e
A suicidal client with a history of manic behavior is admitted to the ED.
The client’s diagnosis is documented as Bipolar I disorder current episode depressed. What is the rationale for this diagnosis instead of a diagnosis of major depressive disorder?
a) The physician does not believe that the client is suffering from major
depression
b) The client has experienced a manic episode in the past
c) The client does not exhibit psychotic symptoms
d) There is no history of major depression in the client’s family
b
Bipolar 2
One or more hypomania episode
Hypomania is less sever episode of mania that last 4 days
A nurse is planning care for a client who had bipolar disorder and is experiencing a manic episode.
Which of the following interventions should the nurse include?
a) Provide flexible client behavior expectation
b) Offer concise explanations
c) Establish consistent limits
d) Disregard client concerns
e) Use firm approach with communication
B improve pt’s ability to focus
C decrease the risk for pt’s manipulation
E provide structure and minimize pt inappropriate behavior
a) NOT flexible, established!!
consistent 一貫性のある
manipulation 操作
Disregard 無視
A pt is brought to the ED b a family member who reports the pt stopped taking a mood stabilizer. The pt indicates a manic episode.
What is the priority nursing diagnosis?
a) Imbalanced nutrition: less body requirements related to not eating
b) Risk for injury related to hyperactivity
c) Disturbed sleep pattern related to agitation
d) Ineffective coping related to denial of depression
b
Safety is the #1 priority!!
A nurse is caring for a client who has bipolar disorder. which is the priority nursing action?
a) Set consistent limits for expected client behavior
b) Administer prescribed medications as schedule
c) Provide the client with step-by-step instructions during hygiene activities
d) Monitored the client for escalating behavior
d for safety
Safety is #1!!!
a) b) c) Not priority for safety
A nurse is teaching about ETC.
Which following statements indicate newly nurse understanding?
a) ECT is the recommended initial treatment for bipolar
b) ECT is contraindicated for client who have suicidal ideation
c) ETC is effective for client who are experiencing sever mania
b
