Bipolar disorder Flashcards Preview

Psurg > Bipolar disorder > Flashcards

Flashcards in Bipolar disorder Deck (28):
1

Etiology of Bipolar d/o

genetic, too much NE and 5-HT, transmembrane CA2+ (that's why Ca+ blockers work for manic pregnant pt), neuroanatomical factors, medication s/e

2

types of bipolar d/o

bipolar 1, bipolar 2, cyclothymic d/o;

3

which bipolar d/o has acute mania?

bipolar 1 only

4

cyclothymic d/o is

a fluctuation of mood in a limited range; at least 2 yrs of episodes of hypomania and depressed mood of insufficient severity or duration to meet criteria for bipolar I or II

5

cyclothymic rapid cycler is

x4+ episodes per year

6

acute Mania is

seen in bipolar I only, euphoria and nonfunctioning; elation, frequently labile, fragmented thought, favorite color is red, often psychotic, flight of ideas, disorganized, hypersexuality d/t low impulse control and no bounderies (sex precaution); also safety issue (can assault or be assaulted); excessive pyschomotor activity, decreased need for sleep, hygiene neglect, flamboyant and bizarre, excessive make-up/jewelry (sharpied eyebrows)

7

hypomania is

irritable and highly productive; cheerful, expansive, underlying hostility, volatile and fluctuating; exalted self perception, easily distracted by irrelevant stimuli, difficulty with goal directed activities, increased motor activity, extroverted, sociable, increased libido

8

Elevated mood s/s for mania

expansive, flight of ideas, decreased sleep, grandiose ideas

9

Bipolar II is

depression with hypomanic episodes; better functioning than Bipolar I

10

Lithium will

decrease TSH, so outer eyebrow don't grow

11

Bipolar with psychotic features: Mood congruent

grandiose delusions (it is plausible)

12

Bipolar with psychotic features: Mood INcongruent

Delusion of control, persecutory delusions, thought inertion (ppl sending pt messages)

13

Delirious Mania Concern

frenzied then may die from exhaustion; #1 concern is SAFETY

14

Delirious Mania characteristics

very labile, unrestrained ecstasy to despair, panic or anxiety, confused/disoriented, religiosity/grandeur/persecutory delusions, extremely distractable, incoherent

15

Nursing dx for Mania

Risk for injury, impaired social interaction d/t no bounderies, feeding self care deficit (finger foods on the go), insomnia (no sleep = more stress); risk for violence self/other directed, imbalanced nutrition: less than body requirements, disturbed thought process, disturbed sensory perception

16

If manic, activities should be

repetitive and simple

17

Risk for Injury Intervention for mania

low stimuli, private room, remove hazards, stay with agitated pt, talking down, provide physical activities, tranquilizer, Olanzapine 15mg PO qd

18

Risk for violence: self other directed intervention for mania

observe q15min, remove dangerous objects, be calm, talking down, sufficient staff, tranquilizer, Olanzapine 15mg PO qd, mechanical restraints

19

Imbalanced Nutrition: less than body requirement intervention for mania

high protein, high calorie finger foods, juice snacks on unit, I&Os, calorie count, daily wt, provide favorite food, supplement with vitamins and minerals, sit with pt during meals

20

3 Stages of bipolar d/o (mania)

1) hypomania, 2) acute mania, 3) delirious mania

21

What is your last resort for tx mania?

physical restraints

22

renew md order for physical restraints

q4 hrs for adults; q1-2hrs for children

23

always choose (x) for physical restraint

least restrictive

24

unconventional self tx of mood d/o

magnet, herb, accupuncture

25

self medicating tx of mood d/o

illlicit drugs

26

Diet and Lithium

need lots of salt and 2.5-3L of fluids/day

27

hold lithium, blood serum >

1.5 mEq/L and call MD

28

community resources

depression and bipolar support alliance (dbsalliance.org); national alliance on mental illness (nami.org)