chapter 12: bipolar disorders Flashcards

1
Q

bipolar disorder

A

a disorder characterized by mood swings from profound depression to extreme euphoria w/ intervening periods of normalcy

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2
Q

bipolar disorder terms

A
  • cyclothymic
  • hypomania
  • mania
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3
Q

cyclothymic

A

characterized by chronic mood disturbance involving numerous episodes of hypomania and depressed mood with less intensity

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4
Q

hypomania

A

a mild form of mania

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5
Q

mania

A

predominant mood that is elevated, expansive, or irritable w/ frenzied motor activity. also known as “manic episodes”

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6
Q

types of bipolar disorders

A
  • bipolar I
  • bipolar II
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7
Q

bipolar I

A

the classic image of bipolar disorder w/ manic symptoms and mst likely depressive episodes

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8
Q

bipolar II

A

-recurrent bouts of major depression w/ episodic occurrence of hypomania. this pt may never have experienced a full episode of mania

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9
Q

cyclothymic

A

a chronic mood disturbance of at least a 2 year duration involving numerous episodes of hypomania and depressed mood but of less intensity

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10
Q

causes of bipolar disorder

A
  • altered levels of serotonin, dopamine, and/or norepinephrine will have an effect on mood. Increased levels are believed to be present in manic episodes and decreased in depressive ones
  • genetics
  • a combination of genetics and biochemical factors along w/ environmental triggers such as stressful life events may present the most comprehensive picture
  • medical conditions and medications can trigger an episode in susceptible people
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11
Q

facts about bipolar disorders

A
  • 4.4% of the American population will suffer from this disorder in their lifetime
  • affects males and females at approximately the same rate
  • episodes may or may not be associated w/ periods of depression
  • average age of onset is 25
  • after the first episode, there is a high risk of recurrence
  • some have periodic episodes separate by years and others have much more frequent cycles
  • most common cause of postpartum psychosis
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12
Q

symptoms

A
  • the manic phase may last from days to months and cause marked disruption of occupational and social functioning. it can include psychotic features
  • depressed phase of bipolar disorder in similar to those described for major depressive disorders in chapter 11
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13
Q

manic symptoms

A
  • very elevated mood
  • excess activity (hyperactivity)
  • increased energy
  • racing thoughts, flight of ideas
  • taling a lot
  • very high self esteem (false beliefs about self or abilities)
  • easily distracted
  • little need for sleep (may feel rested after 3 hours of sleep)
  • poor temper control, easily agitated and irritable
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14
Q

reckless behavior and lack of self control in mania including

A
  • drinking and/or drug use, binge eating
  • poor judgment
  • sex w/ many partners (promiscuity)
  • spending sprees
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15
Q

in the early phase of a manic episode…

A

an individual can become more engaging and outgoing w/ high achievements, energy, and success
- as a manic phase accelerates, this individual can become frenzied and out of control, leading to impaired decision making and potentially hazardous actions

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16
Q

medical treatment

A
  • mood stabilizer medications are the primary treatment
  • psychotherapy helps w/ support and medication compliance
17
Q

mood stabilizers

A
  • lithium
  • anticonvulsants including carbapazepine, gabapentin, valproic acid, lamotrigine
  • additional medications may include antianxiety and antipsychotic drugs in some patients
18
Q

lithium monitoring

A
  • lithium requires close monitoring including regular blood levels
  • therapeutic levels are between 0.5-1.2 milliequivalents per liter for most patients (1.0=1.5 in acute mania)
  • the blood levels can become elevated in dehydration, profuse sweating, and chronic diarrhea leading to toxicity
  • toxicity can cause tremors, confusion, seizures, coma, and even death
19
Q

early warning signs of lithium toxicity include

A

nausea
vomiting
sedation

20
Q

nursing interventions for bipolar disorders

A
  • patience
  • monitor lithium levels: monitor for side effects
  • promote honest/therapeutic communication
  • provide consistency in care
  • encourage healthy nutrition
  • encourage appropriate activity
  • provide clear, firm limits
  • ensure patient safety