Bipolar DisorderBipolar Disorder
What It IsWhat It Is
• Biological origin, Psychological experiences
• Chronic, and recurrent
• Lifetime management
• Alter...
PrevalencePrevalence
• Lifetime prevalence in US: 5.1%
• Emerge between ages 18 – 30
• Bipolar I: males ↑, Bipolar II: fem...
ComorbidityComorbidity
• Substance abuse disorders- very high
• Personality disorders (Borderline)- poorer
outcomes
• Anxi...
TheoryTheory
• Biological Theories
– Genetics (chromosomes 13 &15)
– Neurobiological
– Neuroendocrine
• Psychological Infl...
AssessmentAssessment
• Level of Mood
• Behavior
• Thought Processes & Speech Patterns
• Cognitive Function
• Self-Assessme...
Nursing DiagnosisNursing Diagnosis
• Risk for injury
• See Table14-1, p. 289
• Remember to choose nursing diagnoses
that f...
Outcome CriteriaOutcome Criteria
• Based on which phase of illness client’s in
• Acute
– Prevent injury
• Continuation of ...
PlanningPlanning
• Acute
– Medical stabilization
– Safety
– Self-care needs
• Continuation
– Maintain medication complianc...
InterventionsInterventions
• Acute
– Hospitalization, Firm & calm
– Short, concise, neutral, and consistent limits, remain...
PsychopharmacologyPsychopharmacology
• Mood Stabilizers
– Lithium
– Anticonvulsants: Depakote (Divalproex, Valproic
acid),...
EvaluationEvaluation
• Were outcome criteria met?
• If not, Why?
• Re-assess
• Revise the plan
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Bipolar disorder

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Bipolar disorder

  1. 1. Bipolar DisorderBipolar Disorder
  2. 2. What It IsWhat It Is • Biological origin, Psychological experiences • Chronic, and recurrent • Lifetime management • Alternating mood episodes – Mania – Hypomania – Depression – Concurrent mania and depression • Periods of normal function alternate w/ periods of illness
  3. 3. PrevalencePrevalence • Lifetime prevalence in US: 5.1% • Emerge between ages 18 – 30 • Bipolar I: males ↑, Bipolar II: females ↑ • 1st Episode: – Males: more likely manic – Females: more likely depressed • Episodes ↑ in # & severity with aging • Cyclothymia: – Usually begins in adolescence/early adulthood – 15% - 50% risk of developing Bipolar I or II
  4. 4. ComorbidityComorbidity • Substance abuse disorders- very high • Personality disorders (Borderline)- poorer outcomes • Anxiety disorders (Panic attacks, phobias) • Oppositional Defiant Disorder • SAD • Physical disorders
  5. 5. TheoryTheory • Biological Theories – Genetics (chromosomes 13 &15) – Neurobiological – Neuroendocrine • Psychological Influences – Triggered by an event perceived as stressful • Environmental Factors
  6. 6. AssessmentAssessment • Level of Mood • Behavior • Thought Processes & Speech Patterns • Cognitive Function • Self-Assessment
  7. 7. Nursing DiagnosisNursing Diagnosis • Risk for injury • See Table14-1, p. 289 • Remember to choose nursing diagnoses that fit the symptoms
  8. 8. Outcome CriteriaOutcome Criteria • Based on which phase of illness client’s in • Acute – Prevent injury • Continuation of Treatment – Relapse prevention: • Client/family psychoeducation • Support groups/Therapy • Communication & Problem-solving skills • Maintenance Treatment – Focus on preventing relapse and limiting severity & duration of future episodes
  9. 9. PlanningPlanning • Acute – Medical stabilization – Safety – Self-care needs • Continuation – Maintain medication compliance – Prevent relapse • Maintenance – Prevent relapse – Limit severity and duration of future episodes
  10. 10. InterventionsInterventions • Acute – Hospitalization, Firm & calm – Short, concise, neutral, and consistent limits, remain neutral – Re-direct to positive activities – Medication management – ECT – Milieu therapy: Seclusion • Continuation – Health teaching: Psychoeducation • Maintenance – Psychotherapeutic approaches – Support groups • See Table 14-2 (pp. 291-292)
  11. 11. PsychopharmacologyPsychopharmacology • Mood Stabilizers – Lithium – Anticonvulsants: Depakote (Divalproex, Valproic acid), Lamictal (Lamotrigine), Tegretol (Carbamazepine), Topamax (Topiramate), Neurontin (Gabapentin) • Anxiolytics – Ativan (Lorazepam), Klonopin (Clonazepam) • Atypical Antipsychotics – Zyprexa (Olanzapine), Seroquel (Quetiapine), Abilify (Aripiprazole)
  12. 12. EvaluationEvaluation • Were outcome criteria met? • If not, Why? • Re-assess • Revise the plan
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