Biological basis & more
These are some predisposing factors in the development of a manic episode in bipolar disorder.
What is excessive levels of glutamate, right-reduction in brain activity, and medications could predispose mania?
An individual embarking on complex tasks such as writing a novel despite lack of experience or talent, and speaking highly about their actions is an example of this.
What is grandiosity?
The hyperactive state of mania may have this effect on the patient's nutritional status.
What is the patient may have difficulty sitting still long enough to eat meals?
The nurse should seek ways to provide nutrition during the day.
An alternative to lithium.
What is Depakote?
Antidepressants could cause this is as much as 40% of patients with depression.
What is triggering a switch from depression to mania in individuals with undiagnosed bipolar disorder?
A full manic episode may emerge during antidepressant treatment. The antidepressants should be stopped.
A 15-year-old patient is diagnosed with cyclothymic disorder. The nurse knows the patient has met what diagnostic criteria?
What is symptoms have caused significant impairment in functioning and the depressive symptoms do not meet the criteria for major depressive episode?
The essential feature of cyclothymic disorder is a chronic, fluctuating mood disturbance involving numerous periods of hypomanic symptoms and periods of depressive symptoms. The hypomanic symptoms are of insufficient number, severity, and or duration to meet full criteria for a hypomanic episode. There is an initial 2-year period (or 1 year for children) that symptoms must be present. Cyclothymic disorder usually begins in adolescence.
A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day is considered this type of episode. During this period, there are three or more of the following (increased self-esteem, decreased need for sleep, more talkative, flight of ideas, etc.)
What is a manic episode?
This is the premise to the recovery model for patients with bipolar disorder.
What is independent management?
This is a troublesome side effect of lithium but does not warrant discontinuation or trial of another agent.
What is weight gain?
Nurses would help patients to make healthy food choices such as limiting sugary drinks and exercising regularly to combat the metabolic side effects. Weight gain would not warrant discontinuing the drug.
There is an increase in thyroid hormones and increased norepinephrine in these two disorders.
What are bipolar disorder and panic disorder?
Excessive levels of this neurotransmitter are responsible for symptoms of hallucinations and delusions.
What is dopamine?
A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day. Symptoms do not significantly impact daily functioning.
What is hypomania?
A patient taking an antipsychotic develops a high fever. This could be a sign of this dangerous condition.
What is agranulocytosis?
This is the first line treatment for children with bipolar disorder.
What are second generation antipsychotics?
Name this jerking movement in serotonin syndrome
What is myoclonus?
Myoclonus are sudden involuntary muscle jerks or twitches.
Increased prolactin levels are associated with disorder.
What is depression?
High prolactin levels are associated with depression and also schizophrenia; decreased libido, anxiety, and irritability.
Obsessions are controlled by this class of medications.
What are SSRIs?
A patient takes propranolol for hypertension and also antipsychotics for schizophrenia. The nurse would teach the patient to do this when changing positions.
What is change positions slowly?
This is the rationale for why MAOIs cannot be taken with SSRIs.
What is a hypertensive crisis can result?
Name a benzodiazepine given for anxiety.
What is diazepam?
Diazepam is the most common prescribed benzo for anxiety.
Remember benzos should not be given long term, short term use is best.
Memory deficits and decreased motor function are associated with this neurotransmitter.
What is acetylcholine?
This neurotransmitter is implicated in the decision to commit suicide.
What is serotonin?
A young patient is taking Ritalin for ADHD. The nurse administers the medication at this point in relationship to meals.
What is immediately after meals?
A patient taking antidepressants wants to stop taking after a few weeks because they aren't feeling an effect. This is the nurse's response.
What is advising the patient to continue taking the medication, as results may take four weeks or more?
A patient is taking an antipsychotic and experiences "EPS symptoms." These are examples of EPS symptoms.
What are tremors and a shuffling gait?