Term
| bipolar disorder is biological in its origins and feels like a psychological experience T or F? |
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Definition
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Term
| bipolar d/o is a chronic, recurrent illness, T or F> |
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Definition
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Term
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Definition
| marked by shifts in a persons mood, energy, and ability to function. alternating mood episodes are characterized by manis, hypomania, depression and concurrent mania and depression. |
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Term
| ____% of ppl w/ bipolar disorder fail to regain full occupational and social functioning |
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Definition
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Term
| t or f, bipoar disorder isnts associated with the highest lifetime rate of suicide than compared to any other psychiatric illness |
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Definition
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Term
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Definition
| one episode of mania alternating with major depression |
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Term
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Definition
| hypomanic episodes alternating with major depression |
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Term
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Definition
| hypomanic episodes alternating with minor depressive episodes (at least two years duration) |
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Term
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Definition
| 4 or more mood episodes in a 12 month peroid |
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Term
| t or f, rapid cycling indicates more severe symptoms sucj as poorer global functioning, high reoccurance risk, and resistance to conventional somatic tx. |
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Definition
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Term
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Definition
| unequivocal change in functioning that in uncharasteristic of the person w. not symptomatic, disturbance in mood and the change in functioning are observed by others, absence of marked impairment in social/occupational functioning, hospitalization not indicated, and symptoms not due to direct physiological effects of substance |
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Term
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Definition
| ID** sever enough to caused marked impairment in occupational activities, usual social activites, or realtionships, necessitates hospitalixation to prevent harm to self or others, and symptoms are not due to direct physiological effects of substance. |
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Term
| prevelence of bipolar disorder: |
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Definition
| ranges from 1.2% to 1.6% usually merging from ages 18-30 |
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Term
| whats more common in males, bipolar 1 or 2? |
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Definition
| bipolar 1, and the first episode is likely to be a manic apisode and the episodes incrase in number and severity as person ages |
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Term
| what kind of bipolar is women more likely to get and how is it usually first seem? |
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Definition
| women usually have bipolar 2 and it presents with a depressive episode usually. |
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Term
| prevelence of cyclothymia |
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Definition
| ususally begins in adolescents or early adulthood and there is a 15-50% risk that will develop a bipolar disorder |
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Term
| T or F: substance abusing ppl will expierience more rapid cycling? |
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Definition
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Term
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Definition
| biological, socialogical findings, and psychological |
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Term
| biological theories of bipolar d/o |
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Definition
| genetic factors, neurobiological factors, neuroendocrine factors, and neuroanatomical factors. |
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Term
| which bipolar d/o may have psychotic and display bizarre behavoirs and paranoia symptoms? |
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Definition
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Term
| whichbipolar d/o will experience more attempts of suicide, display d/o;s in temperment, and ddepressed more in winter than in summer? |
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Definition
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Term
| genetic factors involving the theories of bipolarism |
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Definition
| research has identified 2 genes, G72 and G30, located on the long arm of chromosomes 13, which is also associsated with schizo |
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Term
| neurobiological factors in the theories of bipolarism |
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Definition
| neurotransmitters like norepinephrine , dopamine, and serotonin have casual factors in mania and depression. |
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Term
| neuroendocrine factors in the theories os bipolarism |
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Definition
hypothalamic - pituitary-thyroid-adrenal axis has been associated with this d/o
ppl with hypothyroidism is associated with depressed moods and experience rapid cycling |
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Term
| neruanatomical factors of bipolar theories |
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Definition
| patho of bipolar is implaicated in the prefrontal cortex and medial temporal lobe. |
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Term
| socialocical findings on theories of bipolarism |
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Definition
| ppl with bipolar d/o appear to acheive higher levels of education and higher occupational status than nonbipolar depressed ppl |
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Term
| psychological influences on the theories of bipolarism |
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Definition
| associated of high expressed emotion and relapse, also abused children revealed an earlier onset faster cycling, and increase cormorbid disorders |
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Term
| early diagnosis and proper tx can prevent: |
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Definition
| suicide, substance abuse, marital problems, and development of medical comorbidity |
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Term
| assessing mania, you have to look at 4 things which are... |
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Definition
| mood, behavoir, thought processes, and cognitive function |
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Term
| assessing level of mood in someone that is mania |
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Definition
| may state that he is an intense feeling of well being, irratibility and belligerence maybe short lived, cheerful mood may be inappropriate to the circumstances, may laugh, joke and talk in a continuous stream with uninhibited familiarity, energy and and self confidence is boundless, may talk about getting rich and famous making excessive phone calls and emails (often to famous ppl), and often gives away expensive gifts / money. |
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Term
| assessing behavior during mania |
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Definition
| person goes from one activity to another often not finishing them, constantly pushing limits that push away friends and family, is too busy to eat sleep, or engages in sex--> this nonstop activity and lack of sleep/food can lead to physical exhaustion and even death=emergancy , dressing maybe bizzare and inappriopiate and judgement is very poor |
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Term
| how people feel after they come down from a manic episode? |
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Definition
| often feel startled and confused by the shambles in there lives |
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Term
| assessing thought processes in a manic ppl |
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Definition
| flight of ideas, speech is rapid, maybe disorganized and incoherent, often using puns and jokes, often is often sexually explicit and vugar, themes ususally involve sex, good business ability, and artistic talents, speech is very loud, clang associations, grandiosity (stating they know famous ppl or exaggerate achievements, or may think god talks t them), and lastly hallucinations may occer |
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Term
| assessing cognitive function |
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Definition
**core feature of bipolar** includes:
effects overall function, deficits correlate with # of episodes, early diagnosis helps, and drug choice should consider not only efficacy but cognitive impact |
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Term
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Definition
| manipulative tactic in which the client pits one person or group against another |
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Term
| with caring for these pts, whats the numver one thing staff all have to do to carry out care effectively? |
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Definition
| consistancy among steff is imperative if the limit setting is to be carried out!!!!! |
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Term
| what are the goals for acute phase mania? |
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Definition
**#1 goal is to prevent injury!
hydration, cardiac staus, tissue integrity, sleep, and no voilence |
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Term
| phase 2, continuation tx phase of mania goals are... |
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Definition
(last 4 to 9 months)
**relapse prevention!
psychoeducational classes, support groups and communication and problem solving skills training |
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Term
| goals for phase 3 the maintenance tx phase: |
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Definition
**focus on prevention of relapse and limit severity/duration of future episodes**
-participation in learning interpersonal strategies for work and relationships, psychotherapy, |
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Term
| planning for an acute phase pt: |
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Definition
| focus on stabilizing the client while maintaining safety, hospital is usually the safest place, derease activity, increae food, encourage sleep, and help with self care needs |
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Term
| phase 2, the continuation phase planning: |
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Definition
| (last 4-9 months) focus on maintaining compliance and preventing relapse, assess pts interpersonal and stress reduction skills, substance abuse, socual support systems, and cognitive functioning, psychoeducation is a much for client and family, |
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Term
| planning for phase 3 maintenance phase of mania: |
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Definition
| preventing relapse and limiting the severity and surant of future episodes by using psychothereapy, support groups, periodic evaluations on soscial, family and work life |
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Term
| why do some people stop taking there meds? |
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Definition
| some clients are reluctant to give up the incrase energy, euphoria, and heightened sense of self esteem of hypomania |
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Term
| how to communicate someone who is in acute mania? |
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Definition
| firm cal approach, set limits, have a neutral manner, short concise explanations, have frequent staff meeting, firmly redirect energy into more appropriate channels |
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Term
| two main interventions for an acute phase maniac person: |
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Definition
| psychopharmacology and seclusion |
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Term
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Definition
effective in acute tx of mania and prevention for recurrent episodes, usually 1st choice of tx,
***this is not a cure!!!!! |
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Term
| how many days does it take lithium to absorb? |
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Definition
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Term
| lithium is effective in reducing symtotims like... |
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Definition
grandiosity, flight of ideas, irritability, anxiety,
---to a lesser extent, it also helps insomnia, psychomotor agitation, violent behavior, distractibility, paranoia, and hypersexualy. |
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Term
| the therapeutic level of lithium in the blood? |
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Definition
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Term
| actual maintenance blood levels should be: |
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Definition
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Term
| how long does it take to reach therapuetic levels in lithium? |
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Definition
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Term
| at what level can be tosic with lithium? |
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Definition
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Term
| adverse reactions of lithium carbonate> |
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Definition
| START LOW AND GO SLOW!!!! blood levels should be taken to avoid toxicity!!!! |
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Term
| early signs of lithium toxicity: |
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Definition
| nausea, vomiting, diarrhea, thritst, polyuria, slurred speech and muscle weakness --> meds should be held! and blood drawn! |
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Term
| signs of sever lithium toxicity: |
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Definition
ataxia, blurred vision, clonic movements, large output of dilated urine, seizures, stupor, confusion, incontinence, coma, and even death!!!!!
**NO KNOW ANTIDOTE** stop meds, gastric lavage and maybe even hemodialysis! |
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Term
| what to teach the pt about lithium>? |
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Definition
| purpose and requirements of therapy, its adverse effects, its toxic effects and S&S, **suddently stopping lithium cna lead to relapse!!!holla |
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Term
| what are two major risks associated with long term use of lithium> |
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Definition
| hypothyroidism, and impairment of the kidneys ability to concentrate urine |
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Term
| examples of antiepileptic drugs: |
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Definition
| depakote, lamictal, tegretol, topamax, amd neurontin |
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Term
| clients who should take antiepileptic drugs (AEDs) vs lithium |
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Definition
| dysphoric mania, rapid cycling, electroencephalographic abnormalities, substance abuse, progression in frewuency and severity, and no family history , helpfull in alchol and benzodiazepine withdrawal |
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Term
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Definition
its an AED, valproic acid helps in acute mania, ppl w/ rapid cycles, dysphoric mania, or who have not responded to carbamasepine
**monitor live function and plately count! |
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Term
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Definition
its an AED, ok for acute and maintance therapy,
life threatening complication:
life threatening rash!!! (seriously! |
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Term
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Definition
AED, works better with rapid cycling and severely paranoid, angry, maniac clients
**blood levels need to be taken, can cause bone marrow suppression and liver inflammation |
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Term
| anxiolytics for bipolar examples: |
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Definition
| klonopin and ativan, tx of acute mania but should be avoid with a history of substance abuse |
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Term
| antipsychotics for tx of bipolarism |
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Definition
has sedative proporties,
zyprexia is better tolerated and preent manis relapse more effectively then lithium, seroquel also works well (atypical) |
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Term
| ECT therapy for bipolarism tx |
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Definition
| for severe manic behavior and rapid cycling |
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