Mania
A client struggling with a manic episode is showing hypersexual behaviors and is undressing in front of other patients. What is the appropriate nursing intervention at this time?
Accompany the client to their room so that they can get dressed
If a newly admitted patient with bipolar disorder is talking loudly, walking back and forth rapidly and exhibiting a very short attention plan on the behavioral health unit, what should the nurse do first?
Decrease the client's environmental stimuli.
What might a 70 year old patient be surprised to know about depression?
That depression at this age can come on suddenly and without a specific reason.
If a patient states that he is "better off dead," should the nurse know that this type of talk is considered to be suicidal ideation and can lead to the patient actually committing suicide?
Yes
Sertraline (zoloft) is given to a patient for their new diagnosis of major depressive disorder. After one week, the patient does not believe that the medication is working. What should the nurse educate the patient related to the patients concern?
"These medications usually take a few weeks to start showing an improvement to your symptoms."
What should the nurse say to the patient who has not slept in two (2) days due to them experiencing a manic episode? Note that the patient is also dancing around in the activities room and playing loud music.
"Let's go to another room, where it is quiet and talk for a while."
Name one thing that might help a patient that is struggling with sleep.
(Possible answers: avoid caffeine, excessive fluids, alcohol)
How can the nurse help the patient who is experiencing lethargy and apathy but still agrees to participate in group activities with the other patients?
Provide structured activities to facilitate the completion of one task at a time.
What kind of a risk is the patient who states they have a plan and the means?
Suicide
The toxic range of lithium carbonate starts at what?
1.5 mEq/L and above
What would be the overall goal of a patient in psychiatric rehab, that they gain control of?
Control of their symptoms
When the nurse is putting together a care plan for a mental illness/behavior problem, she/he would want to focus on what two patient needs? Hint: both of these one word needs start with a "P"
Psychological and physical needs.
What do neurochemical influences of neurotransmitters (chemical messengers) focus on as the two major biogenic amines implicated in mood disorders?
Serotonin and norepinephrine.
Is it appropriate for the nurse to state "Are you planning to commit suicide" if the patient states, "my wife would be better off without me!"
Yes.
When is the patient, who has a past medical history of suicidal ideation, at risk for self-harm after starting his antidepressant medication?
Approximately Two weeks.
You might find that a person with this diagnosis is often seen as having a flight of ideas.
Manic
What is it called when a patient is walking back and forth down a hallway and they are talking very fast, very loud and using dramatic hand gestures? (hint: they are demonstrating what?)
Pstychomotor agitation
Who has stated that "depression is anger turned inward?"
Freud
No
What should the nurse educate the patient on as it relates to their new MAOI medication and their diet?
The patient should eat a Tyramine-restricted diet.
If extrapyramidal side effects (EPS) happen from taking antipsychotic (neuroleptic medications), what should the nurse do? (hint: remember ch. 16 (pg. 259)
Discontinue the drug as ordered.
If the patient with bipolar complains to the nurse that her symptoms are not improving with the lithium alone. What can the nurse expect that the MD will next order to help with her symptoms? (hint: what class of drug?)
Anticonvulsants
What is a common side effect of ECT?
memory loss (should return in a few weeks)
What should the nurse ask the patient if they admit to having a "death wish" or is having suicidal thoughts? (hint: part of assessment)
"Do you have a plan?" "If so, what is it?"
A patient taking Lithium should know that a lack of dietary salt intake can have what kind of an effect on their lithium levels?
Increase. (Salt is down, Lithium is up)