Chapter 17 Flashcards
______ is characterized by mood swings from profound depression to extreme euphoria (mania), with intervening periods of normalcy
Bipolar Disorder
Individual is experiencing, or has experienced, a full syndrome of manic or mixed symptoms - may also have experienced episodes of depression
Bipolar I Disorder
Recurrent bouts of major depression. Episodic occurrences of hypomania. Pt has not experienced an episode that meets the full criteria for mania or mixed symptomatology.
Bipolar II Disorder
Chronic mood disturbances that have occurred for at least 2 years. Numerous episodes of hypomania and depressed mood
Cyclothymic Disorder
Bipolar has excess of ______, _______, and/or ________.
Norepinephrine, serotonin, and/or dopamine
_____ is the most common comorbid condition with bipolar disorder
ADHD
What should be included in care for pt in manic phase?
A) Focus client’s interest in reality
B) Encourage pt to talk as much as needed
C) Redirect client’s excess energy to constructive channels
D) Persuade client to complete every task started
C - best thing to do with a pt that is manic is to get them doing something. Constructive channel for their excess energy
Symptoms do not sufficiently severe to cause marked impairment in social or occupational functioning or to require hospitalization. Mood is cheerful and expansive. Easily distracted, increased motor activity; extroverted; superficial
Hypomania (Stage I)
Intensified of hypomanic symptoms; often requires hospitalization. Mood is euphoric and elation. Cognition is fragmented, disjointed thinking, pressured speech; flight of ideas; hallucinations and delusions. Excessive psychomotor behavior; increased sexual interest; inexhaustible energy; goes without sleep; bizarre dress and make-up
Acute Mania (Stage II)
Severe clouding of consciousness and an intensification of the symptoms associated with acute mania - has become relatively rare since the availability of antipsychotic medication.
Delirious Mania (Stage III)
Initial symptoms of lithium toxicity are: ______, ataxia, _______, persistent ______ and ______, and severe _______.
Blurred vision, ataxia, tinnitus, persistent nausea and vomiting, and severe diarrhea
What do you use to diagnose bipolar disorder in children ?
FIND:
F - frequency: symptoms occur most days of a week
I - intensity: symptoms are severe enough to cause extreme disturbances
N - number: symptoms occur 3 or 4 times a day
D - duration: symptoms occur 4 or more hours a day
Symptoms of mania: extremely happy, silly, or giddy is _____.
Euphoric/expansive mood
Symptoms of mania: hostility and rage, often over trivial matters is _______.
Irritable mood
Symptoms of mania: believes abilities to be better than everyone else’s is _______.
Grandiosity
Symptoms of mania: may only sleep 3 hours per night and wake up feeling rested
Decreased need for sleep
Valporic acid is an ______
anticonvulsant
Verapamil is a _______
calcium channel blocker
Seroquel is a _________
Atypical antipsychotic
The 4 main drug classes that treat the mania phase are:
Lithium carbonate, anticonvuslants, calcium channel blocker, and atypical antipsychotics
______ may increase risk for depression and suicide
Anticonvulsants
Pt taking lithium needs to ensure that they consume adequate _____ and ____.
Sodium and fluids
Side effects for _____ are: blurred vision, ataxia, tinnitus, persistent nausea and vomiting, and severe diarrhea
Lithium toxicity
Side effects for ______ are: nausea and vomiting, drowsiness; dizziness, bloody dyscrasias, prolonged bleeding time
Anticonvulants - prolonged bleeding time for valporic acid only
Side effects of ____ are: drowsiness; dizziness, hypotension; bradycardia; nausea; constipation
Verapamil
Side effects of _____ are: hyperglycemia and diabetes, drowsiness, dizziness, dry mouth, constipation, increased appetite, weight gain, extrapyramidal symptoms
Antipsychotics - Hyperglycemia and diabetes especially with atypical like Zyprexa
Mechanism of action for ECT is _______.
Monoamines
