WCU mental health Ch. 13 Bipolar Questions with correct Answers

what is bipolar disorder? - Answer- a chronic, recurrent illness of mania and depression what is bipolar 1 disorder? - Answer- -at least 1 week long manic episode -results in excessive activity and energy mixed with depression/agitation -psychosis can occur with mania -more common in males what is bipolar 2 disorder? - Answer- -LOW LEVEL mania alternates with profound depression -hypomania lasts about 4 days - NO psychosis -more common in females what is cyclothymic disorder? - Answer- -hypomania alternates with mild/moderate depression (not severe enough to be bipolar) -occurs for atleast 2 years in adults and 1 year in children -irritability and sleep disturbance -begins in adolescence or early adulthood what is rapid cycling? - Answer- four mood episodes in a 12 month period - more severe symptoms - poorer global functioning - higher recurrence risk -resistance to conventional somatic treatment cultural considerations - Answer- - upper socioeconomic - professionals -creative DSM IV criteria (mood- AT LEAST) - Answer- - 4 days for hypomania - One week for mania DSM-IV criteria (3 symptoms) - Answer- - Inflated self-esteem, or grandiosity - Decreased need for sleep - More talkative than usual - Flight of ideas - Distractability Mood - Answer- Euphoric mood- is unstable. - boundless enthusiasm and confidence - excessiveness -know no strangers - elaborate schemes - give away things and buy high expensive things Hypomanic to Manic: Sociality and euphoria to hostility, irritability, paranoia Behavior - Answer- -Hyperactivity -Bizarre and colorful dress -Highly distractible, uncompleted projects -Impulsive (spending money, cheating) -SLEEP DISRUPTION (non stop activity and no sleep= EMERGENCY) Thought process/speech - Answer- -Flight of ideas * speech is rapid, verbose, circumstantial (minute and unnecessary info)......leads to disorganized and incoherent speech -Grandiosity -Poor judgment - excessive talking (jokes and teasing) clang associations - Answer- stringing together of words b/c of their rhyming sounds, without regard to meaning "cinema, last row. row row row your boat. don't be a cutthroat. cut your throat. get your goat. go out and vote" Cognitive function - Answer- - Significant and persistent problems in 1/3 Dx - Difficulties in psychosocial areas assessment - Answer- - Early diagnosis and treatment can help individuals avoid suicide, alcohol, substance abuse, marital/work problems and development of medical comorbidity. -frequent staff meeting to avoid STAFF SPLITTING (Splits staff and point out their faults) - limit setting (lights out at 11pm...) - consistency among staff 6 steps of assessment - Answer- 1. Assess danger to client or others 2. Protect client from consequences of over-generosity (bankruptcy) 3. Assess need for hospitalization 4. Assess medical status -mania may be secondary to another medical condition - may be related to substance abuse 5. Assess for co-existing conditions needing special intervention 6. Assess client and family understanding How to ASSESS for danger!! - Answer- - Assess for suicidal thoughts or plans - May exhaust themselves to the point of death in manic state - May not eat or sleep for days at a time - Poor impulse control - Poor judgment what to do if your feeling overwhelmed, confused, or angered by a patient? - Answer- - collaborate with the multidisciplinary team - assess supervision with nursing faculty - share your experience with peers in post conference Diagnosis - Answer- For acute mania - prevention of exhaustion and death from cardiac collapse Risk for injury is likely - due to poor judgement, excessive and constant motor activity, probable dehydration, difficulty evaluating reality risk for other-directed violence, sleep deprivation, defensive coping, ineffective coping, self-care deficit, caregiver role strain, impaired verbal communication, impaired social interaction outcomes- Acute Phase - Answer- * injury prevention - be well hydrated -maintain stable cardiac status - get sufficient sleep and rest - make no attempt at self harm outcomes- Continuation Phase - Answer- *4-6 mnth, RELAPSE PREVENTION ALSO -education -therapy -medication control -communication training outcomes- Maintenance Phase - Answer- * prevention of relapse and limitation of the severity and duration of future episodes Planning- Acute Phase - Answer- 0-2 months - Maintain safety - Medication stabilization - Self-care