Bipolar d/o
Describe this behavior: "I am a top college professor from California." Patient is laughing with staff and then abrasively asks nursing student "What are you doing here?"
Agitated, grandiose, labile mood.
This condition appears to have a connection to bipolar disorder in adolescents.
What is ADHD?
This is the therapeutic level for lithium.
What is 0.6 to 1.2 for maintenance therapy?
Review level for lithium toxicity.
This is the FDA approved medication for depression in children.
What is fluoxetine (Prozac)?
This would be taught during social skills training.
What are ways to make eye contact when communicating?
This is a potential problem when patients with bipolar disorder, who are manic, forget to eat. Can be described in this nursing diagnosis.
What is inadequate metabolic needs?
Altered nutrition: less than body requirements AEB weight loss
Describe the epidemiology of bipolar disorder.
What is an equal incidence between men and women, the average onset is 25 years, and it occurs more frequently in higher socioeconomic classes with an overrepresentation among socially active, creative individuals.
Name antipsychotics that may be used for psychosis that occurs during bipolar disorder.
What are olanzapine and risperidone?
True.
There is a strong genetic factor in the etiology of affective illness, including both depression and bipolar disorders.
Psychotic symptoms arise from an increase in this neurotransmitter.
What is dopamine?
Increased production or release of dopamine at nerve terminals causes psychotic symptoms. Remember, psychotic symptoms include hallucinations and delusions. Review the differences between hallucinations and delusions.
These are examples of mood stabilizers that may be used if lithium is not an option
What are lamotrigine (Lamictal), carbamazapine (Tegretol), and valproic acid (Depakote)?
This is the recommended dose for lamotrigine.
What is 100 mg to 200 mg per day?
This is an affective symptom of persistent depressive disorder (dysthymia).
What is a gloomy outlook, feeling sad and down for a long time?
This is the serious side effect that may occur when an SSRI and an MAOI are given together.
What is a hypertensive crisis?
This is always the nurse's priority when a patient has hallucinations.
What is safety?
Ask the patient what are you hearing? to assess if they are experiencing command hallucinations.
This is the reason for the use of an antipsychotic during the manic phase.
What is reduction in hyperactivity and provides sedation while mood stabilizer reaches therapeutic level?
This is the difference between hypomanic and manic episodes.
What is hypomanic episodes are not severe enough to cause marked impairments in social or occupational functioning or to require hospitalization, and it does not include psychotic features?
This is a common side effect of doxepin.
What is orthostatic hypotension?
These are foods to avoid when taking an MAOI.
What are ripened and aged foods high in tyramine, such as aged cheese, red wine, beer, chocolate, and smoked and processed meats?
"The neophim sent me here" is an example of this.
What is a neologism?
This is a newly invented word that is meaningless to others but has symbolic meaning to the patient.
Name one side effect that could become a problem.
What is weight gain?
This is the primary objective for hospitalized patient with bipolar disorder.
What is protecting from injury?
Consider the harm that can occur at either pole (manic or depressive).
Patients taking these drugs should avoid diets high in tyramine.
What are isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and selegiline (Emsam)?
This is the reason why SSRIs are most commonly prescribed for depression.
Patients must adhere to diets and avoid other agents that may interfere with TCAs and MAOIs, and this can be challenging for patients.
If a patient becomes agitated, the nurse should do this.
What is provide adequate space between the nurse and patient to respect the patient's space, which may reduce anxiety and threat of violence?