bipolar disorder

Question 1

bipolar disorder

Answer 1

extreme mood fluctuations from mania to depression; may have periods of euthymic mood, can be mania or hypomania, may also have mixed episodes

Question 2

type 1 vs type 2 bipolar disorder

Answer 2

type 1: full mania
type 2: hypomania

Question 3

mixed episode bipolar

Answer 3

mania and depression rapidly cycling throughout the day

Question 4

hypomania

Answer 4

periods over active or excited behavior that can have a significant impact on day to day life

Question 5

when does bipolar disorder occur

Answer 5

onset in late teens to early thirties

Question 6

which episodes have sudden onset; how long do they last

Answer 6

manic; last from one week to several months

Question 7

symptoms of mania

Answer 7

talking excessively, racing thoughts, hostility, less sleep, delusions

Question 8

symptoms of depression

Answer 8

extreme fatigue, prolonged sadness, memory loss, poor nutrition

Question 9

triggers in bipolar disease

Answer 9

insufficient amounts of sleep, altercations with loved ones, alcohol and drug misuse, certain antidepressants and other medications, pregnancy and other hormonal conditions, a change in season

Question 10

mania

Answer 10

distinct period where mood is abnormally and persistently elevated, expansive or irritable

Question 11

sx of mania

Answer 11

inflated self-esteem and grandiosity, decreased need for sleep and increased activity and/or psychomotor agitation, excessive and pressured speech, excessive involvement in pleasure seeking or risk taking behaviors, deny problems and blame others, may have delusions and/or hallucinations

Question 12

sx of hypomania

Answer 12

cheerful, enthusiastic, abnormally elevated or especially irritable mood, does not impair ability to function, excessive and pressured speech, decreased need for sleep and increased activity and/or psychomotor agitation

Question 13

effects of age of onset on prognosis

Answer 13

earlier onset, tend to have more frequent episodes; newly diagnosable in children, more likely to have irritability and rage

Question 14

in what ways is bipolar a progressive conditions

Answer 14

time between episodes decreases as symptoms progress

Question 15

effect of age on symptoms

Answer 15

incidence of mania tends to decrease with age; older adults have more neurological and cognitive effects

Question 16

assessment of pts. with bipolar disorder

Answer 16

general appearance and behavior: risk taking, sexually suggestive
speech (rapid, pressured, flight of ideas, clang associations)
thought process (circumstantiality)
mood (grandiose, euphoric)
exaggerated self-concept with labile emotions

Question 17

interventions for pts with bipolar

Answer 17

safety, encourage medication compliance and socially appropriate behavior

Question 18

preventing manic episodes

Answer 18

maintain regular sleep and eating schedules, encourage appropriate social interactions, explain the need for continued medication treatment, early crisis intervention for stressful life events

Question 19

what are somethings that can cause a manic episode

Answer 19

medication non-adherence, stressful life events, disruption in social rhythms

Question 20

interventions for pts. with bipolar disorder

Answer 20

encourage ADLs, set limits on inappropriate behaviors, provide high protein finger foods and encourage hydration, avoid triggering situations due to labile mood, distraction is one of the most effective tools, provide a structured environment

Question 21

pharmacological interventions for BPD

Answer 21

mood stabilizers, antipsychotics if active hallucinations or delusions, do not administer anti-depressants without concurrent mood stabilizer

Question 22

non-pharmaceutical treatment methods for BPD

Answer 22

psychotherapy (mildly depressive)
not effective during manic stages d/t disturbances in cognition and judgement

Question 23

lithium

Answer 23

normalizes reuptake of neurotransmitters.

Question 24

why do you have to maintain current intake of sodium

Answer 24

its a salt substance.
increased salt intake causes lower lithium levels
decreased salt intake causes increased lithium levels and potential toxicity

Question 25

lithium levels must be monitored. what is the goal? how often do you check?

Answer 25

1 mEq/L
monitor levels at least every week until dose and stabalized

Question 26

side effects of lithium side effects

Answer 26

edema of hands/feet, fine hand tremor, mild diarrhea, metallic taste, polyuria

Question 27

symptoms of mild lithium toxicity, value?

Answer 27

<1.5mEq/L
exaggeration of expected side effects
metallic taste in mouth, nausea, polyuria, polydipsia, diarrhea, muscle weakness, weight gain, edema

Question 28

symptoms of moderate lithium toxicity; value?

Answer 28

1.5-2.5 mEq/L
severe diarrhea, dry mouth, n/v, ataxia, incoordination, tinnitus, slurred speech, vertigo, muscle twitching, asymmetric deep tendon reflexessssy

Question 29

symptoms of moderate lithium toxicity; value?

Answer 29

1.5-2.5 mEq/L
severe diarrhea, dry mouth, n/v, ataxia, incoordination, tinnitus, slurred speech, vertigo, muscle twitching, asymmetric deep tendon reflexes

Question 30

symptoms of severe toxicity; value?

Answer 30

> 2.5 mEq/L
fasciculations, nystagmus, coarse tremors, cardiac arrhythmias, hallucinations, oliguria, peripheral vascular collapse, confusion, seizures, coma

Question 31

anticonvulsant agents

Answer 31

mood stabilizers
ex. carbamazepine, valproic acid, topiramate, lamotrigine