NRSR 23 Unit 1: Bipolar and Related Disorders

Question 1

Bipolar I Disorder

Answer 1

The client has at least one episode of mania alternating with major depression.

Question 2

Bipolar II Disorder

Answer 2

The client has one or more hypomanic episodes alternating with major depressive episodes.

Question 3

Cyclothymia

Answer 3

The client has at least 2 years of repeated hypomanic manifestations that do not meet the criteria for hypomanic episodes alternating with minor depressive episodes.

Question 4

Morbidities associated with bipolar disorder

Answer 4

• Substance use disorder
• Anxiety disorders
• Eating disorders
• ADHD

Question 5

Clinical Manifestation:

Manic Characteristics

Answer 5

• Labile mood with euphoria
• Agitation and irritability
• Flight of ideas
• Grandiosity
• Impulsivity
• Poor judgment
• Decreased sleep, etc….

Question 6

Clinical Manifestation:

Depressive Characteristics

Answer 6

• Flat, blunted, labile effect
• Tearfulness crying
• Lack of energy
• Anhedonia
• Self-destructive behavior
• Suicidal ideation
• Disturbed sleep & appetite, etc…

Question 7

Nursing Care

Answer 7

-Focus on safety and maintaining physical health.
-Therapeutic milieu
>Provide safe environment
>Assess for suicidal thoughts,
intentions, escalating
behaviors.
>Decrease stimulation
>Provide rest periods, outlets
for physical activities.
>Communication: calm, concise
matter-of-fact.

Question 8

Medications

Answer 8

-Lithium carbonate: eq. (Lithobid)
-Anticonvulsants: eq. valproic
acid, clonazepam, lamotrigine
-BDZ: eq. lorazepam (Ativan)

Question 9

Patient Education

Answer 9

-Teach long-term pharmacological
 & psychological support
-Benefits of psychotherapy &
 support groups to prevent
 relapse.
-Importance of sleep, meal &
 activity pattern.
-Precipitating factors of relapse:
 eq. sleep disturbance, alcohol, 
 caffeine, drug abuse.
-Adherence to med admin.