Chapter 24 - Bipolar Flashcards
Elevated mood
Euphoria and elation
Expansive mood
lack of restraints in expression
overvalued self-importance
Irritable mood
Easily annoyed and provoked
What lab would the nurse want to check for a pt. w/o a Hx of Bipolar disorder but presents with all symptoms
Thyroid
What may cause symptoms of bipolar related to medications?
Previous use of antidepressants
Discontinuation of mood stabilizers
Priority intervention for bipolar
Safety - homicidal and suicidal ideation
Med used to Tx bipolar
Lithium and Anticonvulsants
If in sighting harm: Antipsychotics
Anticonvulsants
Diva can’t have carbs but lambs
Divalproex
Carbamazepine
Lamotrigine
Other intervention for bipolar
Therapy
Relaxation techniques
Stress management
Plan for emerging symptoms
Normal Lithium Levels
0.6-1.2
Mild Lithium Toxicity
< 1.5
Moderate Lithium Toxicity
1.5-2.5
Severe Lithium Toxicity
> 2.5
Splitting is a characteristic of what disorder?
Borderline personality Disorder
Mild Lithium Toxicity Symptoms
Confusion, tachycardia, polyuria, polydipsia, GI upset, metallic taste
Moderate Lithium Toxicity Symptoms
N/V, severe diarrhea, dry mouth, dizzy, ataxia, slurred speech
Severe Lithium Toxicity Symptoms
Cardiac arrhythmias, hallucinations, oliguria, seizures, coma, death
ACE inhibitors and Lithium
ACE inhibitors = high lithium
Fluoxetine (SSRI) Inhibitors and Lithium
Fluoxetine (SSRI) = high lithium
NSAID and Lithium
NSAIDS decrease lithium excretion = high lithium
Alcohol and Lithium
Alcohol = high lithium
Sodium and Lithium
High sodium = low lithium
How long must the pt. have a persistant elevated, expansive, or irritable mood to be diagnosed with Bipolar?
1 week
Focused assesments for bipolar disorder:
Appetite
Sleeping
Activity
