Questions and Answers
What is the diagnostic criterion for Bipolar 1?
What are the diagnostic criteria for Bipolar 2?
What is a manic episode?
A period of at least 1 week of elevated, expansive or irritable mood with significant goal-directed activity.
What characterizes a hypomanic episode?
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What does rapid cycling refer to in bipolar disorder?
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What are some genetic risk factors for bipolar disorder?
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What nursing assessments are important for manic symptoms?
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What is an appropriate nursing intervention for a manic episode?
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What does lithium do in the treatment of bipolar disorder?
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What does ECT stand for in the context of bipolar disorder treatment?
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What are warning signs of a prodrome in the first manic episode?
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What is the focus of Group Psychoeducation?
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Study Notes
Bipolar Disorder Diagnostic Criteria
- Bipolar 1: Requires one lifetime manic episode; major depressive episode not necessary.
- Bipolar 2: Involves one hypomanic episode and one major depressive episode; no manic episodes occur.
Manic and Hypomanic Episodes
- Manic Episode: Lasts at least one week; marked by elevated or irritable mood and significant goal-directed activity. Symptoms must impair functioning and include inflated self-esteem, decreased sleep, racing thoughts, and risky behaviors.
- Hypomanic Episode: Lasts at least four days; similar symptoms to mania but does not severely impair functioning and lacks psychotic features.
Rapid Cycling and Atypical Features
- Rapid Cycling: Characterized by four or more episodes within 12 months; women are at higher risk, particularly related to menstrual cycles.
- Atypical Features: Include mood reactivity, weight changes, hypersomnia, and heightened sensitivity to interpersonal rejection.
Age of Onset and Genetic Factors
- Average onset of bipolar symptoms occurs during late adolescence to young adulthood.
- Genetic predisposition is significant; identical twins have a 70% risk, while children of affected parents face risks ranging from 15-75%.
Nursing Assessment and Management
- Assess for manic symptoms: sleep deprivation, irritability, weight loss, risky behaviors, and substance use.
- Mental status evaluations show flamboyant appearance, pressured or incomprehensible speech, and grandiose, paranoid, or psychotic thoughts.
Nursing Responsibilities
- Monitor mental status and promote healthy sleep and activity patterns.
- Identify stressors early to minimize functional impairments; address safety concerns, especially regarding risk-taking behaviors and potential suicide.
Communication Strategies
- Use a calm, firm approach with concise explanations; avoid engaging in power struggles or humor.
- Establish clear limits and redirect excessive energy.
Nursing Interventions During Acute Mania
- Reduce environmental stimuli, provide structured activities, and keep verbal interactions brief.
- Implement safety measures and monitor for medication side effects; increase fluid intake and ensure adequate rest.
Pharmacologic Treatments
- First line treatment: Lithium is primary for managing bipolar disorder.
- For acute mania, use antipsychotics (e.g., Haldol, Olanzapine), mood stabilizers (Divalproex), and long-acting benzodiazepines for sleep.
Group and Individual Therapies
- STEP-BD (Systematic Treatment Enhancement Program) includes pharmacotherapy and therapies such as interpersonal psychotherapy, social rhythm therapy, family therapy, and CBT.
- Group psychoeducation promotes mutual support and recovery skills among patients.
Sleep Hygiene Practices
- Encourage a regular sleep schedule, balanced diet, limited caffeine and alcohol intake, exercise, and relaxation techniques to promote better sleep.
Treatment of Psychotic Depression and ECT
- Treatments involve both antidepressants and antipsychotics, or ECT for severe cases; effects usually noticed within a week, with multiple sessions required.
Nursing Interventions for ECT
- Prior to ECT, complete necessary lab tests, ensure safety by removing loose objects, and prepare for sedation.
- Post-ECT care includes monitoring vital signs, ensuring the airway is maintained, and providing reassurance.
Postpartum Psychosis
- Can manifest within three weeks after delivery; characterized by severe mood disturbances, delusions regarding the baby, and potential harmful ideation.
Nursing Care for Postpartum Psychosis
- Prioritize safety for mother and child; assess for suicidal or homicidal thoughts, administer medications, and educate the family on the illness while fostering a non-judgmental environment.
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Description
This quiz covers the diagnostic criteria for Bipolar Disorder, including Bipolar 1 and Bipolar 2. It delves into manic and hypomanic episodes, rapid cycling, and atypical features. Test your understanding of the key concepts and symptoms associated with these conditions.
