Bipolar and PTSD Flashcards
(24 cards)
signs and symptoms of mania
inflated self-esteem cheerful irritable pressured speech flight of ideas psychomotor agitation decreased sleep risk-taking psychotic features
hypomania
period of abnormal and persistent elevated mood
productive for 4 days (don’t crash)
depression
sad mood hypersomnia or insomnia lack of energy impaired concentration and decision-making worthlessness, hopelessness, despair death or suicide
bipolar I
manic episodes with at least one depressive episode
bipolar II
recurrent depressive episodes with at least one hypomanic episode
bipolar mixed
alternates between major depressive and manic episodes interspersed with periods of normal behavior
lithium
first choice for treatment of acute mania; less effective in people with mixed features and rapid cycling
dose for lithium
300mg PO TID
contraindications for lithium
renal and cardiac disease, sodium-depletion dehydration, diuretic use, pregnancy
adverse effects for lithium
CNS problems, gastric toxicity, ECG changes, CV collapse, severe hyponatremia
nursing considerations for lithium
monitor serum levels (0.6-1.2)
adequate intake of salt and water (2L/day)
if client intakes too much salt or water, this can lower lithium levels
if client does not intake enough salt or water, this can raise lithium levels
monitor weight and I+Os
monitor for toxicity
assess renal function
lithium toxicity
nausea and vomiting diarrhea slurred speech reduced coordination drowsiness muscle weakness CALL PHYSICIAN!!
nursing management of bipolar disorder
providing safety meeting physiologic needs managing medications providing therapeutic communication promoting appropriate behaviors teaching
providing safety
if patient is being violent, get everyone else out of the room and if patient is just being disruptive, get him/her out of the room
nutritional needs
provide short, quick food for the patient; do not give full meals
signs and symptoms of PTSD
re-experiencing the trauma (dreams, flashbacks)
emotional numbing (feeling detached)
hyperarousal (hypervigilance, irritability)
avoidance (avoid places or people)
negative cognition and mood (persistent self-blame)
psychosocial issues (depression, anxiety, substance use, decreased interest, inability to remember)
risk factors for children
children with parental depression and abuse (one or both parents are depressed) and adolescents
screening for PTSD
primary care PTSD screen is a 4-item screen; if client answers yes to any three questions, they should be referred to a mental health professional; they should also be screened for suicidal ideation
promoting self-esteem of survivors for PTSD
patient should be the victim instead of the survivor
treatment for PTSD
cognitive behavioral therapy such as exposure therapy, adaptive disclosure, cognitive processing
exposure therapy
exposure person to trauma until he/she is able to cope with it
adaptive disclosure
structured (6 weeks) with trauma; combines exposure therapy and open chair therapy
cognitive processing
work on correcting faulty assumptions
grounding techniques
prevents dissociation and detachment from reality (pulling on rubber band)
