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psych bipolar
management bipolar disorder
| Question | Answer |
|---|---|
| list the side effects of lithium | mild shakiness(fine hand tremor), thirst, increased urination, weight gain, discomfort, diarrhea, vommiting, drowsiness, muscle weakness, coordiantion problems ( do a EKG and renal function test ) |
| what are some teaching to do with administering lithium | while taking lithium you will need frequent blood tests, included tests to measure the level of lithium in your blood and kidney function test |
| depakote common side effects | tiredness, dizziness, upset stomach, vomiting, tremors, hair loss, weight gain, and changes in behavior |
| anticoculsanats side effects | see slides |
| reason that antipsychotocs and benzodiazepines are used in acute mania | benzodiazepines rapidly help control manic symtoms until mood stabilizing drugs can take effect ; they slow the activity of the brain; slow speech, inhibit aggression, dcrease pyschomotor activity; prevent exhaustion, coronary collapse, death |
| enhances the reuptake of biogenic amines in the brain lowering levels in the body and resulting in decreased hyperactivity | lithium |
| early signs of lithium toxicity? and what will the blood level be | 1.5 ; n/v/d thirst, polyuria, slurred speech, muscle weakness |
| advanced signs of lithium tox and blood level? | 1.5-2.2 ; coarse hand tremor , persisten gi upset, mental confusion, muscle hyperirritablity, incoordination |
| Severe lithium toxicity and blood levels? | 2.0-2.5; ataxia, blurred vision, clonic movements, large output of diluted urine, seizures, stupor, sever hypotension, coma |
| severe lithium toxicity continued and blood leve | confusion, incontinence of urine or feces, coma, cardiac arrhythmias, peripheral circulatory collapse, abdominal pain, proteinuria, oliguria, death |
| long term risks for taking lithium | hypothyroidism, impairment of kidneys ability to concentrate urine |
| when teaching client and family about lithium therapy you would want include | effects of treatment; monitor lithium blood levels, side effects and toxic effects; hydration , effect of food and otc meds; when to call the doctors |
| when taking depakote | it should be taken with food and not with coumadin or nsaids, dont take with carbonated drinks, avoid alcohol, causes birth defects, avoid sunlight |
| when taking depakote the lab test that need to be done | baseline platelet counts, bleeding times, serum ammonia repeat ever 2 months esp during the first 6 months of therapy |
| what is the major way in which nursing intervention differs in an acute crisis | 1. focuses on the problem or stressor that precipitaed the crisis rather than on personality traits. 2. views people in crisis as normal and capable of problem solving and growth w/ asst. from others 3. goal is to assist ppl in distress to resolve immprob |
| what is the last major way in which nursing intervention differes in an acute crisis | problem solving should lead to enhanged coping to deal with future stressful events (see slide) |
| what are the types of crisis | maturational ( developmental ) situational adventitious |
| results from normal life events that cause stress | maturational |
| maturational crisis | new developmental stage is reached, old coping skills no longer are helpful, ineffective defense mechanisn until new coping skills develop |
| develops as a response to a sudden and unavoidable traumatic even that dramatically alters a persons identity ad roles | situational |
| outside external event that causes trauma and disruption, usually to many peopl | adventitious |
| crisis from a external source: loss of a job, severe illness, divorse | situational |
| unplanned and accidental; natural disaster, national disaster, crime of violence | adventitious |
| list the steps in crisis intervention. | 1. crisis assessment 2. establish quick rapport 3. id major problems 4. deal with feelings - listen 5. explore options-jointly 6. develop an action plan 7. agree to follow up |
| what outcomes can occur in crisis intervention | |
| What is the primary concern during a crisis? | #1 nursing diagnosis r/t danger to self or others |
| assessment criteria for mania.... | page 553 |
| incidence of bipolar disorder | affect approx. 1% (2-2.5 million) of us population 18y/o ; average age of first manic episode is 18-20years; earlier age of onset -worst outcomes, 20% suicide, 50% comorbidity with substance abuse |
| etiology of bipolar disorder | combination-interaction of genes, neurobiology, environment, life history, development |
| biological theories of bipolar disorder | 80% identical twins, possible excess of norepinephrine and dopamine, dyregualtion of serotonin and dopamine systems; hypothalamic-pituitary-thyroid-adrenal axis, dysregualtion in neurological circuits; brain lesions; medication se |
| nursing diagnosis for pt with bipolar disorder | Risk for violence; Risk for injury ; Impaired verbal communication ; Disturbed sleep patterns r/t inability to sleep ;Altered nutrition (less ); Defensive coping ;Ineffective coping ;Disturbed thought processes;Situational low self-esteem |
| what are some possible nursing outcomes for a pt with bipolar disorder | impulse self control, agression self control, selfcare status, social interaction skills, concentration, compliance behavior |
| what are some possible interventions for a pt with bipolar disorder | page 562; shrt stepbystep instructions,collaberate with staff for boundries and enforce them, redirect energy to contructive tasks, low levels of stimuli, direct to eat/drink, valuables in safe, frequet rest, neutral, nonjudgemental |
| treatment options for bipolar disorder are : | psychoeducation, cognitive behavioral therapy; family therapy; interpersoanl and social rhythm therapy, lithium depekote, antipsychotics, symbyax, sleep deprivation, transcranial magnetic stimulation, vagal nerve stimulation |
| you are going to teach what to family dealing with bipolar disorder | causes, cyclic nature of illness, symptoms of depression, symptoms of mania, medication management. |
Created by:
ameliarae
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