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Mental Health-MJ > T1-Bipolar Disorder & Suicidal Client > Flashcards

T1-Bipolar Disorder & Suicidal Client Flashcards

1
Q

A pervasive and sustained emotion that may have a major influence on a person’s perception of the world

A

Mood

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2
Q

Examples of mood?

A 
Depression
Joy
Elation
Anger
Anxiety
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3
Q

The emotional reaction associated with an experience

A

Affect

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4
Q

An alteration in mood that is expressed by feelings of elations, inflated self-esteem, grandiosity, hyperactivity, agitation, and accelerated thinking and speaking

A

Mania

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5
Q

How can mania occur?

A
  • Biological (organic) disorder
  • Psychological disorder
  • A response to substance use
  • General medical condition
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6
Q

Characterized by mood swings from profound depression to extreme euphoria (mania) with intervening periods of normalcy

A

Bipolar disorder

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7
Q

Are delusions and hallucinations part of bipolar disorder?

A

May or may not be

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8
Q

What is a somewhat milder form of mania called?

A

Hypomania

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9
Q

What type of bipolar:

  • Client is experiencing, or has experienced, a full syndrome of manic or mixed symptoms
  • Client may also have experience episodes of depression
A

Bipolar 1 disorder

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10
Q

What type of bipolar:

  • Characterized by bouts of major depression with episodic occurrence of hypomania
  • Has never met criteria for full manic episode
A

Bipolar 2 disorder

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11
Q

A suicidal client, with a history of manic behavior, is admitted to the ED. The client’s diagnosis is documented as bipolar I disorder: current episode depressed. What is the rationale for this diagnosis instead of a diagnosis of major depressive disorder?

A. The physician does not believe the client is suffering from major depression.
B. The client has experienced a manic episode in the past.
C. The client does not exhibit psychotic symptoms.
D. There is no history of major depression in the client’s family.

A

B–The clients past history of mania and current suicide attempt support the diagnosis of bipolar 1 disorder

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12
Q

Stage 1: Hypomania

Are symptoms sufficiently severe to cause marked impairment in social or occupational functioning or to require hospitalization?

A

No

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13
Q

What are the characteristics of Stage 1: Hypomania?

A
  • Cheerful mood
  • Rapid flow of ideas, heightened perception
  • Increased motor activity
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14
Q

Stage 2: Acute Mania

Is there marked impairment in functioning? Does this stage of mania require hospitalization?

A

Yes, yes

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15
Q

Stage 2: Acute Mania

Symptoms? (6)

A
  • Elation and euphoria (a continuous high)
  • Flight of ideas, accelerate/pressured speech
  • Hallucinations and delusions
  • Excessive psychomotor activity
  • Social and sexual inhibition
  • Little need for sleep
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16
Q

A grave form of the disorder (mania) characterized by an intensification of the symptoms associated with acute mania.

A

Stage 3: Delirious mania

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17
Q

Is delirious mania common or rare?

A

Rare–bc of antipsychotic medications

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18
Q

What are some characteristics of delirious mania?

A
  • Labile mood, panic anxiety
  • Clouding of consciousness, disorientation
  • Frenzied psychomotor activity
  • Exhaustion and possibly death without intervention!!
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19
Q

Lifetime prevalence of pediatric and adolescent bipolar disorders is estimated at about __.

A

1%

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20
Q

Is it easy to diagnose bipolar disorder in childhood and adolescence?

A

No, difficult! (it is similar to ADHD, so thats why its hard to diagnose)

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21
Q

How have guidelines for diagnosis and treatment been developed for diagnosing bipolar disorder in kids?

A

The Child and Adolescent Bipolar Foundation (CABF)

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22
Q

What does the CABF recommend the use of in making a diagnosis of bipolar disorder in children and adolescents?

A

FIND

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23
Q

What does FIND stand for?

A

Frequency
Intensity
Number
Duration

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24
Q

FIND

  1. Frequency: symptoms occur ____
  2. Intensity: How are the symptoms?
  3. Number: How many times a day?
  4. Duration: How many hours a day?
A

Frequency: Symptoms occur MOST DAYS OF THE WEEK

Intensity: Symptoms are SEVERE enough to cause EXTREME DISTURBANCE

Number: Symptoms occur 3-4x/DAY

Duration: Symptoms last FOUR OR MORE HOURS/DAY

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25
Q

Childhood and adolescence: What are the 11 big symptoms for bipolar disorder?

A
  1. Euphoric/expansive mood
  2. Irritable mood
  3. Grandiosity
  4. Decreased need for sleep
  5. Pressured speech
  6. Racing thoughts
  7. Distractibility
  8. Increase in goal directed activity/psychomotor agitation
  9. Excessive involvement in pleasurable or risky activities
  10. Psychosis
  11. Suicidality
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26
Q

What does it mean if a child is experiencing a euphoric/expansive mood?

A

Extremely happy, silly, or giddy

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27
Q

What does it mean if a child is experiencing an irritable mood?

A

Hostility and rage–ofter over trivial matters

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28
Q

What does it mean if a child is experiencing grandiosity?

A

Believes abilities to be better than everyone elses

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29
Q

What if a child has a decreased need for sleep– How many hours do they get? What do they feel like?

A

May sleep 4-5 hours per night but still wake up feeling rested!

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30
Q

What is pressured speech?

A

Loud, intrusive, difficult to interrupt

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31
Q

What is racing thoughts?

A

Rapid change of topics

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32
Q

What is distractibility?

A

Unable to focus on school lessons

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33
Q

What is increase in goal-directed activity/psychomotor agitation?

A

Activities become OBSESSIVE–increased psychomotor agitation

34
Q

What is excessive involvement in pleasurable or risky activities?

A

Exhibits behavior that has an erotic, pleasure-seeking quality about it

35
Q

What happens if they experience psychosis?

A

May expreience hallucinations and delusions

36
Q

What may the child exhibit if symptoms of suicidality arise?

A

Suicidal behavior during a depressed or mixed episode or when psychotic

37
Q

What is the rest of the nursing diagnosis for bipolar mania RISK FOR INJURY r/t:

A

Bipolar mania risk for injury r/t extreme hyperactivity, increased agitation, and lack of control over purposeless and potentially injurious movements

38
Q

What is the rest of the nursing diagnosis for bipolar mania RISK FOR VIOLENCE: SELF DIRECTED OR OTHER DIRECTED r/t:

A
  • Manic excitement
  • Delusional thinking
  • Hallucinations
  • Impulsivity
39
Q

What is the rest of this diagnosis:

Bipolar mania DISTURBED THOUGHT PROCESSES r/t:

A

Biochemical alterations in the brain AEB delusions of grandeur and persecution and inaccurate interpretation of the environment

40
Q

In the initial stages of caring for a client experiencing an acute manic episode, what should the nurse consider to be the priority nursing diagnosis?

A. Risk for injury related to excessive hyperactivity
B. Disturbed sleep pattern related to manic hyperactivity
C. Imbalanced nutrition, less than body requirements related to inadequate intake
D. Situational low self-esteem related to embarrassment secondary to high-risk behaviors

A

A

According to Maslows hierarchy of needs, maintaining CLIENT SAFETY is ALWAYS A PRIORITY. The impulsiveness and hyperactivity seen in clients diagnosed with acute mania puts them at risk for injury

41
Q

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

A

The recovery model

42
Q

What are some things the client does in the recovery process of bipolar disorder?

A
  • Identifies goals
  • Develop a treatment plan (client and clinician)–and work on strategies to help manage the disorder
  • Clinician= support person to help the individual achieve the goals they make
43
Q

Is there cure for bipolar disorder?

A

No

44
Q

If there is no cure for bipolar disorder, how is recovery possible??

A

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

AKA THERE IS HOPE

45
Q

Who is more at risk for suicide: single or married people?

A

Single

46
Q

Who attempt suicide more? Who succeed more?

A

Attempt: women
Succeed: men

47
Q

Risk of suicide ___ with age (especially among ___)

A

Increase, men

48
Q

White men older than ___ are at greatest risk of all age/gender/race groups

A

80+

49
Q

Affiliation with a religious group ____ risk for suicide.

A

Decreases

50
Q

Who is more at risk: Catholics, Proestants, Jews?

A

Protestants or Jews

51
Q

Individuals in the very highest and lowest social classes ____ suicide than those in middle class.

A

Increase

52
Q

What is the ethnicity order for increased risk of suicide?

A
  1. Whites followed by
  2. Native Americans
  3. African Americans
  4. Hispanic Americans
  5. Asian Americans
53
Q

What is the most common risk for suicidal?

A

Mood disorders

54
Q

What are some other problems that account for suicidal behavior?

A

Substance-Related disorders
Schizophrenia
Personality disorders
Anxiety disorders

55
Q

_____ is associated with increase risk of suicide

A

Severe insomnia

56
Q

Does ETOH and other barbiturates increase or decrease risk for suicide?

A

Increase

57
Q

Does psychosis with command hallucinations put you at risk for suicide?

A

Yes

58
Q

T/F: Chronic painful or disabling illness is an increased risk for suicide

A

TRUE

59
Q

Does family history have anything to do with increased risk of sucide?

A

Yes

60
Q

A mood disorder causing a persistent feeling of sadness and loss of interest

A

Major depression

61
Q

4 S&S of depression?

A
  1. Hypersomnolence (sleep a lot)
  2. Lack of appetitie/ overeating
  3. Anhedonia
  4. Anergic
62
Q

Loss of enjoyment of things that used to make a person happy

A

Anhedonia

63
Q

No energy

A

Anergic

64
Q

An alteration in mood that is expressed by feelings of ELATION, inflated self-esteem, grandiosity, hyperactivity, agitation, and accelerate thinking and speaking

A

Mania

65
Q

Main 3 symptoms of mania?

A
  1. Accelerated mood
  2. Grandiosity
  3. Decreased sleep
66
Q

A lesser degree of mania

A

HYPOmania

67
Q

Why is hypomania often hard to diagnose?

A

May be confused with someone who is outgoing and energetic

68
Q

Are all people with mania happy and elated?

A

NO!!!—some can be angry and agitated

69
Q

What are some disorders that increase risk for suicide?

A

Command hallucinations
Major depressive disorder
Bipolar Mania
Schizophrenia

70
Q

What is a sentinel event?

A

Suicide or injury that occurs in a facility

71
Q

How often do we monitor clients with major depression?

A

IRREGULAR intervals of 15 minute checks! (must be irregular so the client doesnt suspect when you will be coming back)

72
Q

Nursing diagnosis for major depression?

A
  1. Risk for suicide r/t depressed mood, feelings of worthlessness, anger toward self, misinterpretations of reality
  2. Low self esteem r/t learned helplessness, feelings of abandonment by significant others, impaired cognition due to negative view of self
  3. Spiritual distress r/t complicated grieving process over loss of valued object evidence towards anger toward God
73
Q

Should we argue, bargain, or try to reason with a bipolar client?

A

NO

74
Q

What are nursing diagnosis for bipolar disorder?

A
  1. Risk for injury r/t ..

2. Risk for violence: self directed or other-directed

75
Q

What are 3 nursing interventions similar for persons with both major depression and bipolar mania?

A
  1. Unobtrusive observation (line of sight)
  2. Eating
  3. Hygiene (they need to do it themselves)
76
Q

Identify nursing interventions that would be different for persons with both major depression and bipolar mania.

A

Major depression: don’t want to be group leader; may sleep too much

Bipolar mania: May want to make them a group leader; may be sleeping TOO LITTLE

77
Q

What does SAD PERSONS stand for?

A

Sex (male higher risk)
Age (adolescents, elderly)
Depression

Previous attempt
ETOH use
Rational thinking LOSS
Social support DECREASE
Organized plan
NO spouse
Sickness
78
Q

What is SAD PERSONS assessment used for?

A

To see if a person may be suicidal

79
Q

Nursing diagnosis for suicide?

A
  1. Risk for suicide

2. Hopelessness

80
Q

If caring for a suicidal client, what are some good interventions to do?

A
  • Dont leave person alone
  • No-suicide contract
  • Talk matter of faculty about suicide
  • Identify areas of self control
  • TRUSTING relationship
  • Give antidepressant meds

*these are just a few; there are some others–these seem like most important

Mental Health-MJ (39 decks)

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