Chapter 17 Bipolar Flashcards
a pervasive and sustained emotion that may have a major influence on a person’s perception of the world
mood
the emotional reaction associated with an experience
affect
an alteration in mood that is expressed by feelings of elation, inflated self-esteem, grandiosity, hyperactivity, agitation, and accelerated thinking and speaking
mania
describe bipolar epidemiology
gender incidence is equal
average onset is 20s
more common in single people
more common in increased socioeconomic classes
characterized by mood swings from profound depression to extreme euphoria (mania), with intervening periods of normalcy
bipolar disorder
are delusions and hallucinations part of the clinical picture of bipolar disorder
sometimes
milder form of mania
hypomania
describe bipolar 1 disorder
Client is experiencing, or has experienced, a full syndrome of manic or mixed symptoms.
May also have experienced episodes of depression
describe bipolar 2 disorder
Characterized by bouts of major depression with episodic occurrence of hypomania
Has never met criteria for full manic episode
describe cyclothymic disorder
Chronic mood disturbance
At least 2-year duration
Numerous episodes of hypomania and depressed mood of insufficient severity to meet the criteria for either bipolar I or II disorder
biological causes of bipolar disorder
genetics
excess norepinephrine and dopamine
brain lesion
med side effects
Bipolar disorder is viewed as
a disease of the brain
drug therapy for children with bipolar
Lithium
Divalproex
Carbamazepine
Atypical antipsychotics
what is a common co morbid condition of children with bipolar
ADHD
Symptoms may be categorized by
degree of severity
stage 1 of bipolar
Hypomania: Symptoms not sufficiently severe to cause marked impairment in social or occupational functioning or to require hospitalization
cheerful mood, rapid flow of ideas, increased motor activity
stage 2 of bipolar
Acute mania: Marked impairment in functioning; usually requires hospitalization
elation/euphoria, flight of ideas, hallucinations/delusions, excessive motor activity
stage 3 of bipolar
Delirious mania: A grave form of the disorder characterized by an intensification of the symptoms associated with acute mania. The condition is rare since the advent of antipsychotic medication.
Labile, anxiety, frenzied
Evaluation of the effectiveness of the nursing interventions is measured by
fulfillment of the outcome criteria
treatment modalities for bipolar disorder
Individual psychotherapy
Group therapy
Family therapy
Cognitive therapy
Learning how to live a safe, dignified, full, and self-determined life in the face of the enduring disability which may, at times, be associated with serious mental illness
recovery model
what can be used to treat episodes of mania if pt is not responding to meds
ECT
meds for mania
Lithium carbonate
Anticonvulsants
Verapamil
Antipsychotics
what may trigger mania
antidepressants
anticonvulsant education
Refrain from discontinuing the drug abruptly.
Report the following symptoms to the physician immediately: skin rash, unusual bleeding, spontaneous bruising, sore throat, fever, malaise, dark urine, and yellow skin or eyes.
Avoid using alcohol and over-the-counter medications without approval from physician
what is lithium used for
mania
Verapamil education
Do not discontinue the drug abruptly.
Rise slowly from sitting or lying position to prevent sudden drop in blood pressure.
what symptoms following verapamil should be reported to the physician
Irregular heart beat; chest pain Shortness of breath; pronounced dizziness Swelling of hands and feet Profound mood swings Severe and persistent headache
What is the difference between Bipolar Affective Disorder (BAD) I and II?
1: full mania
2: hypomania and major depression
chronic mood disturbance of at least 2 years in duration and never without symptoms for more than 2 months
cyclothymic disorder
characterized by manic episodes that can but does not have to also occur alongside episodes of depression
BAD
What are nursing diagnoses commonly used with a patient exhibiting mania?
Risk for Injury, Risk for Violence: Self-Directed or Other-Directed, Imbalanced Nutrition: Less Than Body Requirements, and Impaired Social Interaction.
What are the curative factors
installation of hope, universality, imparting of info, altruism, Corrective recapitulation of the primary family group, development of socializing techniques, Imitative behavior, interpersonal learning, Group cohesiveness,Catharsis, existential factors
assimilated by group members to help individuals gain self-esteem through mutual sharing and concern for each other. Providing assistance and support to others creates a positive self-image and promotes self-growth.
altruism
“the individual is taught to control thought distortions that are considered to be a factor in the development and maintenance of mood disorders”
cognitive theory
Bipolar Affect disorder most likely results from an interaction between which three determinants?
Genetic, biological, and psycho-social factors most likely result in Bipolar disorder
when is early onset and very early onset schizophrenia
early: <17
very early: <13
the client is taught to say loudly, “Go away!” or “Leave me alone!” in a conscious effort to dismiss the auditory perception. This activity allows the client to exert some conscious control over auditory hallucinations.
voice dismissal
Is BAD completely treatable, with no further episodes?
In bipolar disorder, recovery is a continuous process. Although there is no cure for bipolar disorder, recover is possible in the sense of learning to prevent and minimize symptoms and to successfully cope with the effects of the illness on mood, career, and social life
