Bipolar Disorders

Question 0

Phases of Bipolar Disorder

Answer 0

1. Acute
2. Continuation
3. Maintenance

Question 1

Bipolar Disorder

Answer 1

1. Bipolar disorders are mood disorders with recurrent epiodes of depression and mania.
2. Usually emerge in late adolescens/early adulthood. Clinical manifestations can minic ADHD symptoms.
3. Periods of normal functioning can alternalte with periods of illness

Question 2

Acute phase

Answer 2

1. Acute mania
2. Hospitalization may be required
3. Reduction of mania and client safety are the goals of treatment
4. Risk of harm to self or others is determined
5. 1:1 supervision may be indicated

Question 3

Maintenance Phase

Answer 3

1. Increased ability to function
2. Treatment continues throughout lifetime
3. Prevention of future manic episodes is the goal

Question 4

Mania

Answer 4

Abnormally elevated mood, which may also be described as expansive or irritable; usually requires hospitalization.

Question 5

Hypomania

Answer 5

a less sever episode of mania that lasts 4 days accompanied by 3-4 findings of mania. Hospitalization, is not required as the client is less impaired.

Question 6

Mixed episode

Answer 6

A manic episode and an episode of major depression experienced by the client simultaneously. The client has marked impairment of functioning and may require admission to an acute care mental health facility.

Question 7

Rapid Cycling

Answer 7

1. 4 or more episodes of acute mania within 1 year, each lasting at least 2 weeks
2. Episodes marked by partial or full remission for at least 2 months or a switch to an episode of opposite type.
3. Associated with high risk of recurrence and resistance to conventional drug treatments.
4. Greater severity of illness & prominent depressive symptoms

Question 8

Bipolar 1 Disorder

Answer 8

The client has at least one episode of mania alternating with major depression.

Question 9

Bipolar 2 disorder

Answer 9

The client has one or more hypomanic episodes alternating with major depressive episodes. No psychotic features does not impair functioning to a level that necessitates hospitalization.

Question 10

Cyclothymia

Answer 10

The client has at least 2 years of repeated hypomanic manifestations that do not meet the criteria for hypomanic episodes alternating with minor depressive episodes.

Question 11

Comorbidities associated with Bipolar Disorder

Answer 11

1. Substance use disorder
2. Anxiety disorders/ psychiatric illness
3. Eating disorders
4. Attention deficit hyperactivity disorder (ADHD)
5. Cardiovascular, Cerebrovascular, & respiratory diseases

Question 12

Risk Factors for Bipolar Disorder

Answer 12

1. Genetics
2. Psychological, stressful events, major life changes
3. Physiological- neurobiological and neuroendocrine disorders
4. Substance use disorder

Question 13

Relapse Triggers

Answer 13

1. Use of Substances
2. Sleep disturbances
3. Psychological stressors

Question 14

Manic characteristics:

Answer 14

1. Grandiose view of self & abilities
2. Impulsivity
3. Restlessness
4. Flight of Ideas
5. Delusions & Hallucinations
6. Denial of illness
7. sleep disturbances
8. speeding sprees
9. hyper sexuality (typically females)

Question 15

Depressive characteristics:

Answer 15

1. Flat, blunted labile affect
2. Tearfulness, crying
3. Lack of energy
4. Anhedonia
5. discomfort, pain
6. difficulty concentrating
7. Decrease in personal hygiene

Question 16

Nursing actions:

Answer 16

1. Prevent Self harm
2. Decrease clients physical activity
3. Ensure adequate fluid and food intake
4. promote an adequate amount of sleep each night
5. assist the client with self-care needs
6. manage medication appropriately

Question 17

Average age of 1st manic episode:

Answer 17

18-20 years, earlier age of onset is associated with worse outcomes, including rapid cycling in adulthood.

Question 18

Associated risk of completed suicide & bipolar illness

Answer 18

15%

Question 19

Desired outcomes:

Answer 19

1. Impulse self-control
2. Aggression self-control
3. Self-care status
4. Social interaction skill
5. Concentration
6. Compliance behaviour

Question 20

Treatment settings:

Answer 20

1. Acute Care
2. Step-down programs
3. Day treatment programs
4. Community-based programs

Question 21

Antidepressant & Bipolar disorder

Answer 21

Usually not appropriate to give someone an antidepressant if pt. is bipolar-> Manic Episode