Bipolar Disorder Flashcards Preview

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Flashcards in Bipolar Disorder Deck (11):
1

Bipolar I

Manic episodes with at least one depressive episode

2

Bipolar II

Recurrent depressive episode with at least one hypomanic episode

3

Mixed Bipolar

Cycles alternate between periods of mania, normal mood, depression, normal mood, mania, and so on.

4

Dx of Manic episodes

abnormal elevated mood for at least 1 week with at least 3 S/S:
DIG FAST
Distractibilty
Indiscretion (behavior or speech that is indiscreet or displays a lack of good judgment.)
Grandiosity
Flight of Ideas/Clang associations
Activity increase
Sleep Deficit
Talkative

5

Hypomania vs Mania

Hypomania:
Talks & jokes—life of 
Talk is sexually familiar
Euphoric, sociable 
Boundless self- confidence
No HCN or delusions 
Overactive, distractible ,buoyant, charismatic
Pleasure seeking—sex, spending money

Mania:
 Mood is labile, laughing to anger
 Talk is profane and crude
 Irritable
Grandiose, out of contact with reality
HCN and Delusions
 Restless, disorganized, chaotic
 Too busy, no time for sex

6

Valproic acid (Depakote) - Ther level, S/E, NI

Ther level: 50-100
May cause liver or pancreatic damage
Baseline LFT and lipase are checked, No for pregnant women.

7

Litium affects on mood

increases mood when depressed, decreases mood when manic

8

Lithium - serum level, NI, patient teaching

serum level: 1.5-2 mEq/L
Avoid dehydration
Contraindicated in thyroid and renal disease
Contraindicated to take diuretic (dehydration)
Maintain normal diet, fluid and salt intake
Take lithium with meals
Stop taking if diarrhea, vomiting or diuressis occurs

9

S/S of lithium toxicity

CAN HAM SUCS
Confusion
An increase in thirst
Nausea
Hand tremors
Ataxia
Muscle twitches
seizure
uncontrollable eye movements
coma
slurred speech

10

Lamotrigine (Lamictal)

Decreases the phase of bipolar,
Watch for skin rash (Steven-Johnon syndrome)
Must titrate up slowly

11

Nursing Communication for mood disorders

 Firm, calm approach
 Short, concise explanations
 Be neutral: avoid power struggles, do not join in joking
 Consistent approach and expectations
 Convey limits, consequences
 Act on legitimate complaints
 Redirect energy