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Mental Health

Mood Disorders: Bipolar

A chronic, recurrent illness that must be carefully managed throughout a person's life. bipolar disorder
Bipolar disorder is marked by shifts ina person's mood, energy, and ability to function.
Alternating mood episodes of bipolar disorder are characterized by mania, hypomania, depression, and concurrent mania and depression.
This disorder is associated witth the highest lifetime rate of suicide of any psychiatric illness. bipolor disorder
Having at least one episode of mania alternating with major depression. Bipolar I disorder
Hypomanic episodes alternating with major depression. Bipolar II disorder
hypomanic episodes alternating with minor depressive episodes and at least 2 years duration. Cyclothymia
_______ is used to indicate more severe symptoms such as poorer global functioning, high recurrence risk, and resistance to conventional somatic treatments. Rapid Cycling
The episode is associated with an ujnequivocal change in functionin that is uncharaceristic of the person when not symptomatic. Hypomania
The disturbance in mood and the change in functioning are observed by others. hypomania
Hospitalization is not indicated for this typ lf bipolar disorder behavior. hypomania
The symptoms of ______ are not due to direct physiological effects of substance. hypomania
______ is sever enough to cause marked impairment in occupational activities, ausual social activities, or relationships. Mania
Necessitates hospitalization to prevent harm to self or others, or there are psychotic features. mania
Symptoms are not due to direct physiological effeccts of substance or general medical condition. mania
The first episode of bipolar disorder in males tends to be a manic episode.
Substance use disorders are exceptionally common in individuals with a bipolar disease
Substance-abusing clinets seem to experience more rapid cycling and more mixed or dysphoric mania in bipolar disorder
A patient must have hypomania for ______ to be diagnosed as having bipolar disorder. 4 days
A patient must have mania for ______ to be diagnosed as having bipolar disorder. 1 week
Associated disorders of bipolar disorder are: personality disorders, anxiety disorders, anorexia nervosa, bulimia nervosa, and attention deficit hyperactivity disorder.
Clinet populatiions with comorbid personality disorders also have a greater tendency toward medication nonadherence
Individuals with _____ may become psychotic or display bizarre behavior and paranoia. Bipolar I disorder
Indiciduals with ______ are more liely to become depressed in winter than in summer, make more suicide attempts, and display disorders in temperment. Bipolar II disorder
People with ______ have a higher lifetime prevalence of anxiety disorder and social and simple phobias, greater disease chronicity,and more subsequent depressions. bipolar II disorder
Bipolar depression is characterized by higher rates of divorce and marital conflict, affects younger people, produces more episodes of illness, and requires more frequent hospitalization.
Bipolar disorders have a strong ____ component genetic
The euphoric mood associated with a bipolar illness is unstable
The irritability and belligerance associated with a bipolar illness may be short lived, or it may become the prominent feature of a person's manic illness.
When a person with bipolar illnes is in a cheerful mood, it may be ________ to the circumstances. inappropriate
In this state, the person often gives away money, prized possessions, and expensive gifts, throws lavish parties, frequents expensive nightclubs and restaurants and spends money freely on friends and strangers alike. manic state
As the clinical course of bipolar disorder progresses, sociability and euphoria are replaced by a stage of hostility, irritability and paranoia
The nonstop physical activity ant the lack of sleep and food when a person is in a manic stage can lead to physical exhaustion and even death if not treated
People often emerge from a _______ state startled and confused by the shambles of their lives. manic
A nearly continuous flow of accelerated speech with abrup changes from topic to topic that are usually based on understandable associations or plays on words. Fkight of ideas
In flight of ideas, the speech is rapid, berbose and circumstantial and the incessant talking often includes joking, puns and teasing
As mania escalates, flight of ideas may give way to clang associations
The stringing together of words because of their rhyming sounds. clang associations
inflated self regard grandiosity
_______ is apparent in both the ideas expressed and the person's behavior. grandiosity
In hypomania, no evidence of ______ or ______ is present. delusions or hallucinations
The client may use humor, manipulation, power struggles, or demanding behavior to prevent or minimize the staff's ability to set limits on and control dangerous behavior
Dividing staff as a ploy to keep the environment unsettled is another unconscious tactic of a _______ client. manic
When the client pits one person or group against another. Splitting
________ among staff is imperative if the limit setting for a manic patient is to be carried out effectively. consistency
The overall goal during the acute phase of maina is to prevent injury
Outcomes in during the acute phase of mania would be: hydration, maintain stable cardiac status, maintain/obtain tissue integrity, get sufficient sleep and rest, demonstrate thought self-control, make no attempt at self harm
The continuation phase lasts 4 to 9 months
The overall outcome of the continuation phase of treatment is prevention of relapse
The overall outcomes for the maintenance phase of treatment is to continue to focus on prevention of relapse and to limit the severity and duration of future episodes.
Planning during the acute phase focuses on medically stabilizing the client while maintaining safety.
Hospitalization is usually the safest place for the client when mania is acute
Planning during the continuation phase focuses on maintaining compliance with the medication regimen and precvn=enting relapse.
Planning during the maintenance phase focuses on preventing relapse and limiting the severity and duration of future episodes.
Intervention during the acute phase includes: Hospitalization if necessary, continuously set limits in a firm nonthreatening and neutral manner to prevent further escalation of mania and to provide safe boundaries for the client and others.
______ is effective in the acute treatment of mania and depressive episodes and the prevention of recurrent mania and depressive episodes. lithium carbonate
Once primary acute mania has been diagnosed, _____ is most often the first choice of treatment. lithium
Some subgroups of bipolar clients may not respond well to lithium but may do well when treated with antiepileptic drugs (AED's)
Anxiolytics are useful in the treatment of ______ in some clients with treatment-resistent mania. acute mania
_______ seem to have mood stabilizing properties. Antipsychotics
In clients with treatment-resistent mania and rapid cycling, ______ is used to subdue severe manic behavior. Electoconvulsive Therapy (ECT)
The _______ provides comfort and relief to many clients who can do longer control their own behavior. seclusion room
The nurse documents the following for a client in seclusion: Behavior leading up to the seclusion or restraint. Actions taken to provide least restrictive alternative. Time placed in seclusion, Q15 min behavior, needs care, and vital signs. Tim and type of medications administered and their effects on the client.
____ and _____ are never to be used as punishment or for the convenience of the staff. restraints and seclusion
The outcome for the treatment continuation phase is to prevent relapse
_____ ______ during the treatment continuation phase is perhaps the most important treatment outcome. medication compliance
Why are changes in sleep pattern especially important for families of bipolar patients to notice? Because they usually predede, accompany, or precipitate mania.
_____ is typically used as an adjunct to pharmacotherapy in treating bipolar disorders. CBT
______ is an important treatment in bipolar illness; it results in greater compliance with the lithium regimen. psychotherapy
A major principle that should be observed when a nurse communicates wit a client experience elated mood is to use a calm, firm approach
A medication teaching plan for a client receiving lithium should include periodic monitoring of renal and thyroid function
Verbosity is a symptom present in a _______ client and is specific to communication. manic
For assessment purposes, the nurse should identify the body system most at risk for decompensation duing a sever manic episode as cardiac
A person who has numerous hypomanic and dysthymic episodes can be assessed as having cyclothymia
Exaggerated belief in one's own importance, identity, or capabilities, is seen with grandiosity
A bipolar client tells the nurse "I have the finest tenor voice in the world. The three tenors who do all those TV concerts are going to retire because they can't compete with me." The nurse would make the assessment that the client is displaying grandiosity
When a hyperactive manic client attempts to strike another client, the initial nursing intervention should be verbal limit setting
What intervention can the nurse suggest when a client reports that lithium gives him an upset stomach? take it with meals
What action should the nurse take on learning that a manic client's serum lithium level is 1.8 mEq/L? Withhold medication and notify the physician. Levels should range between 0.4 and 1.3 mEq/L.
What side effects of lithium can be expected at therapeutic levels? Fine hand tremor and polyuria