Mood Stabilizers: Exam 3 Flashcards
What does the mood scale consist of from the highest mood to the lowest mood?
Highest mood: Mania
Hypomania
Normal mood
Dysthymia
Lowest mood: Depression
Clients that are _________ have poor impulse control, racing thoughts, grandiose beliefs about themselves, and can be a danger to themselves and others. ___________ is a milder version of mania. Clients who have this are very energetic, have a reduced need for sleep, are creative, and may actually get alot of work done. _________ is a persistent, mild form of depression.
Manic
Hypomania
Dysthymia
What moods does Bipolar 1 & 2 consist of?
Bipolar 1 = mania & depression
Bipolar 2 = hypomania & depression
What are the treatment challenges associated with bipolar disorder, since it is difficult to treat.
Clients need a medication regimen that will help push their mood downward and upward at the same time. Naturally this often requires a COMBINATION of meds.
Med ADHERENCE is another challenge. Mood stabilizers can have some unpleasant side effects that may cause clients to discontinue their use.
Many clients ENJOY feeling hypomanic and manic episodes. (ex: they see no reason to take their medications)
What are the 3 major types of medications to take for bipolar disorder?
- Lithium
- Anticonvulsants (i.e. valproic acid, lamotrigine, and carbamazepine)
- Atypical antipsychotics: newer, treats signs and symptoms of bipolar disorder
What is the common uses for lithium?
Long term use medication. Is prescribed for acute manic episodes episodes and for long term maintenance therapy for bipolar disorder. Lithium is not commonly used for other disorders.
Lithium is a ___________ therapeutic index drug. Thus, lithium requires careful dosing, frequent drug level monitoring, careful monitoring for signs of toxicity, and lots of client education.
Narrow
What should a clients serum lithium level be?
it depends on the situation. If the client is currently in a manic phase and is beginning therapy, it needs to be a little on the high side (0.8-1.4 mEq/l). if the client has stabilized, the level can be a little lower (0.4-1 mEq/l)
The most important thing for you to remember is that no one’s lithium levels should be greater than ____ mEq/l. What is this?
1.5
This is because if the clients lithium level is greater than this, you should hold the dose and contact the health care provider, this is a worrisome health problem!!!
What are the expected side effects of lithium?
Mild GI problems (to be expected)
Mild thirst (polydipsia)
Increased urination (polyuria)
fine hand tremors (normal)
What are the signs of toxicity regarding the use of lithium?
When a clients lithium levels rise above 1.5 mEq/l, they start to experience mild toxicity. It’s important that you know these early signs by heart since we want to catch the toxicity EARLYYY. Anytime you administer lithium, you need to do a quick “scan” for toxicity.
What does SCAN mean in regards to lithium toxicity?
S = sadation and slurred speech
C = course hand tremors
A = ataxia (in coordination/clumsy)
N = nausea, vomiting, and diarrhea (persistent): GI probs become more severe more quickly
What is the causes of toxicity?
The kidneys can’t tell the difference between sodium and lithium – both are salts. So if a client eats an unusual amount of salt, the kidneys will try to get rid of all that salt. In so doing, they will also get rid of the lithium. Conversely, if the client loses a bunch of sodium from dieting or sweating profusely, the kidneys will try to hold onto sodium. In so doing, they will also hold onto lithium, causing levels to RISE. The same thing can happen if a client is taking a diuretic.
In order to avoid dangerous fluctuations of lithium levels, clients should:
Maintain __________ amounts of sodium in their diets (no excessive sodium)
Avoid excessive ______________.
Stay well ______________.
Consistent
Sweating
Hydrated
Another big concern is ______________. First, this can be a sign of toxicity. Second, this causes your body to lose alot of sodium. Third, it can lead to dehydration.
Diarrhea
