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Pysch > Bipolar disorder > Flashcards

Bipolar disorder Flashcards

1
Q

Bipolar I disorder

A 
– Most severe form
– Highest mortality rate of the three
– At least 1 manic episode 
duration of at least 1 week
Doesn't have to have MDD dx
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2
Q

Bipolar II disorder

A

– At least 1 hypomanic episode

– At least 1 major depressive episode

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3
Q

• Cyclothymic disorder

A

– Alternate with symptoms of mild to moderate
depression for at least 2 years (adults)
– Rapid cycling possible

Usually begins in adolescence or early adulthood

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4
Q

Other bipolar disorder

A

Substance/medication-induced bipolar and related disorder
• Bipolar and related disorder due to another
medical condition
• Other specified bipolar and related disorder
• unspecified bipolar and related disorder

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5
Q

Assessment of Bipolar disorder

A

Mood:
Behavior: (Manic) disinhibition
Thought processes and speech patterns: disorganized thoughts, challenging to understand, important to know how patient’ speech is at baseline
Cognitive functioning

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6
Q

Speech patterns of bipolar disorder & define

A

–Pressured speech:
– Circumstantial speech:extra detail eventually gets to the point
– Tangential speech: Never gets to the point
– Loose associations: understand how person is putting thoughts together but not closely connected
– Flight of ideas: Ideas that are coming without connections
– Clang associations:Talking and start make up rhymes

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7
Q

Environmental factors impact of bipolar disorders

A

Susceptible to increased stress levels

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8
Q

Hypo vs Hypermania

A

Hypo: brain is working efficiently
Hyper: Looses clarity and becomes disorganized or distressing

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9
Q

Thought content in BP & define

A

Grandiose delusions: most important person in the world, in ways that do not reflect reality
Persecutory delusions: thoughts that People are out to get them, delusions

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10
Q

Anticonvulsant mood stabilizers

A

Valproate (Depakote)
• Carbamazepine (Tegretol)
• Lamotrigine (Lamictal)

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11
Q

Assessment of manic patient

A

–Persuasive and persistent
– Seeks frequent or constant attention
– Splitting

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12
Q

Staff member actions for bioplar patients

A

– Frequent staff meetings to deal with
patient behavior and staff response
– Set limits consistently

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13
Q

Assessment Guidelines for BP

A

-Danger to self or others
• Need for protection from uninhibited
behaviors
• Need for hospitalization (Hospitalization is not preferred)
• Medical status
• Coexisting medical conditions (DM, not eating etc)
• Family’s understanding (

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14
Q

Outcomes identification

A

Acute-Prevent injury
Continuation phase-relapse prevention
Maintenance phase: limit severity and duration of future episodes

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15
Q

Planning

A
  • Medical stabilization
  • Maintaining safety
  • Nursing care
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16
Q

Acute manic phase planning/ treatment

A 
-Medical stabilization
• Maintaining safety
• In-hospital nursing care
ECT may be considered during the acute
phase

Seclusion or restraint may be used as a
LAST RESORT after ALL other
interventions have failed.
Considered a treatment FAILURE!

17
Q

Nursing Care for Acute Mania

Hospitalization

A 
Medication
management
• Decrease physical
activity
• Increase food and fluid
intake
• Ensure at least 4-6
hours of sleep per
night
• Decrease stimulation
• Set limits; insight can
be poor
Refocus and redirect
Anticipate altercations with other and intervene early
18
Q

Nursing care education Re illness/med management

A 
– Strategies for relapse
prevention
– Support and educate
family
– Express hope; share
evidence
19
Q

Two main foci

A

– Agitation

– Mood stabilization

20
Q

Lithium carbonate
– Indications
– Therapeutic and toxic levels

A

• Therapeutic blood level: 0.8 to 1.4 mEq/L
• Maintenance blood level: 0.4 to 1.3 mEq/L
• Toxic blood level: 1.5 mEq/L and above
Dehydration/overhydration effects this

– Maintenance therapy (longer intervals b/w blood tests)
– Contraindications (med interactions, comorbities)

21
Q

First gen antipyschotics

A

side effects
• Chlorpromazine (Thorazine)
• Loxapine (Adasuve) inhaled

22
Q

Other treatments

A 
ECT
• Teamwork and safety
• Seclusion protocol
• Support groups
• Health teaching and health promotion
23
Q

Advanced Practice Interventions

A

Cognitive-behavioral therapy (CBT) (inc coping mechanisms, dec stress impact)
• Interpersonal and social rhythm
therapy
• Family-focused therapy

24
Q

Evaluation

A
  • Evaluate outcome criteria
  • Reassess care plan
  • Revise care plan if indicated

Pysch (3 decks)

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