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Mental Health > Bipolar Disorder > Flashcards

Bipolar Disorder Flashcards

1
Q

What was Bipolar disorder previously called

A

Manic-depression

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2
Q

Is Bipolar acute or chronic

A

Chronic

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3
Q

Is Bipolar a one time thing or recurrent?

A

Recurrent

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4
Q

Bipolar has a ___X higher suicide attempt rate than the general population

A

15

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5
Q

Bipolar disorder is present in ___% of all suicides

A

25

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6
Q

How many types of bipolar is there?

A

3

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7
Q

Type 1 Bipolar is:

A

episodes of major depression plus at least one episode of mania, with our without psychotic symptoms

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8
Q

Type 2 Bipolar is:

A

episodes of major depression plus hypomanic episodes. No psychosis. High suicide risk because mania isn’t as extreme and fun as in type 1

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9
Q

Cyclothymia is:

A

episodes of hypomania and minor depression

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10
Q

What is mania?

A

Extreme “highs” the opposite of depression.

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11
Q

What is hypomania?

A

A lower degree of mania

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12
Q

Diagnostic criteria for Mania

A

*Distinct period of abnormal, persistent, elevated, expansive, or irritable mood
AND
*At least three:
-Inflated self esteem or grandiosity
-Decreased need for sleep(dramatic 5 days)
-More talkative
-Flight of ideas / racing thoughts
-Distractibility
-Increased activity
-Excessive risky pleasure-seeking behaviors

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13
Q

What is rapid cycling?

A
  • 4 or more episodes per year of mania and/or depression

- Tend to be more severe symptoms and less responsive to treatment

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14
Q

What is the lifetime prevalence with Bipolar?

A

3.9%

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15
Q

Comorbidities with Bipolar

A
  • Panic attacks (62%)
  • Alcohol abuse (39%)
  • Social phobia (35%)
  • SAD-seasonal affective disorder (35%)
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16
Q

Etiology (cause) of Bipolar

A
  • Multifactoral
  • Genetic
  • Neurological
  • Psychological or environmental stressors
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17
Q

Genetic Etiology of Bipolar

A

80-90% heritable

  • risk is 5-10X higher if relative has BD
  • Polygenic (multiple genes, not just one)
18
Q

Neurological Etiology of Bipolar

A
  • Prefrontal cortex
  • Medial Temporal Lobe
  • Interaction of multiple neurotransmitters
19
Q

Bipolar Disorder Assessment Mood:

A
  • Euphoria
  • Joyous/cheerful
  • Irritable
  • Talkative/laugh
  • Grandiose plans & Schemes
20
Q

Bipolar Disorder Assessment Behavior:

A
  • Continuous activity without food or sleep can be life-threatening-key nursing priority
  • Spend money, engage in social activities, indiscriminate sexual behavior, start lots of projects
21
Q

Bipolar Disorder Assessment Thought process & Speech

A
  • Flight of ideas
  • Clanging (Rhyming)
  • Profanity
  • Loud, even screaming
  • Grandiosity (Self important)
22
Q

Bipolar Disorder Assessment Cognitive Functioning

A
  • Disease onset preceded by high functioning

- Deficits may develop after onset, worse in type 1

23
Q

What is the focus for nursing diagnosis etc.?

A

Centered around risk for injury, poor self care, neglect of physical needs.

24
Q

Nursing cares for Bipolar in Acute phase:

A
  • Injury Prevention
  • Maintain hydration & nutritional status.
  • Teat MDD
25
Q

Nursing Cares continuation phase:

A
  • 4-9 months after episode

* Relapse prevention is the focus.

26
Q

Nursing Cares Maintenance Phase:

A
  • Ongoing prevention of relapse
  • Limit severity and duration of relapse
  • Ongoing individual or group therapy
  • Participate in strategies to maintain functional level
27
Q

Lithium is used for:

A

First line, acute mania & maintenance

28
Q

Antianxiety agents for agitation or severe acute mania:

A

Clonozepam (Klonopin)

Lorazepam (Ativan)

29
Q

Anticonvulsants used for acute & maintenance:

A

Valproic acid (Depakote)-Most common
Carbamazepine (Tegretol)
Lamotrigiane (Lamictal)-Most common

30
Q

First Generation Anticonculsants used for Maintenance only

A

Oxcarbazepine (Trileptal)

31
Q

Second Generation Antipsychotics (atypical) for Maintenance:

A

Aripiprazole (Abilify)

Quetipine (Seroquel)

32
Q

Second Generation Antipsychotics (atypical) for Acute & Maintenanced:

A

Olanzapine (Zyprexa)
Risperdone (Riperdal)-Most common
Ziprasidone (Geodon)

33
Q

Why did antidepressants used to be avoided?

A

Issues with sending into mania. Now they are used sometimes and monitored closely.

34
Q

Meds used with severe mania

A

Combo of:
Depakote (Valpoate) or Lithium
AND
Zyprexa (olanzapine) or Risperdal (risperdone)

35
Q

What is Electroconvulsive Therapy used for?

A

Severe, treatment resistant mania

Depression-similar criteria to MDD

36
Q

What does seclusion do?

A
  • Reduce overwhelming environmental stimuli
  • Protect against injury to self or others
  • Prevents destruction of property
37
Q

When to use seclusion

A
  • If there is substantial, clear risk of harm
  • Patient is unable to control actions
  • Behavior sustained despite trying other treatments first.
38
Q

Nursing cares with seclusion

A
  • 1:1 care is preferable
  • Documentation of :Preceding behavior, Other actions tried first & response of patient, Time placed in seclusion, Patients behavior, needs, vitals and nursing cares every 15 min, Time, type & effects of meds.
39
Q

What is the age of onset with Bipolar?

A

18-20

40
Q

Patients with Bipolar usually present with what first?

A

Depression

41
Q

What class of people are effected more with Bipolar?

A

Higher Socioeconomic Status

42
Q

What race and/or gender is effected more with Bipolar?

A

-No clear effect of race / ethnicity or gender

Mental Health (5 decks)

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