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Mental Health
Mood Disorders: Bipolar
| Question | Answer |
|---|---|
| A chronic, recurrent illness that must be carefully managed throughout a person's life. | bipolar disorder |
| Bipolar disorder is marked by | shifts ina person's mood, energy, and ability to function. |
| Alternating mood episodes of bipolar disorder are characterized by | mania, hypomania, depression, and concurrent mania and depression. |
| This disorder is associated witth the highest lifetime rate of suicide of any psychiatric illness. | bipolor disorder |
| Having at least one episode of mania alternating with major depression. | Bipolar I disorder |
| Hypomanic episodes alternating with major depression. | Bipolar II disorder |
| hypomanic episodes alternating with minor depressive episodes and at least 2 years duration. | Cyclothymia |
| _______ is used to indicate more severe symptoms such as poorer global functioning, high recurrence risk, and resistance to conventional somatic treatments. | Rapid Cycling |
| The episode is associated with an ujnequivocal change in functionin that is uncharaceristic of the person when not symptomatic. | Hypomania |
| The disturbance in mood and the change in functioning are observed by others. | hypomania |
| Hospitalization is not indicated for this typ lf bipolar disorder behavior. | hypomania |
| The symptoms of ______ are not due to direct physiological effects of substance. | hypomania |
| ______ is sever enough to cause marked impairment in occupational activities, ausual social activities, or relationships. | Mania |
| Necessitates hospitalization to prevent harm to self or others, or there are psychotic features. | mania |
| Symptoms are not due to direct physiological effeccts of substance or general medical condition. | mania |
| The first episode of bipolar disorder in males tends to be | a manic episode. |
| Substance use disorders are exceptionally common in individuals with a | bipolar disease |
| Substance-abusing clinets seem to experience more | rapid cycling and more mixed or dysphoric mania in bipolar disorder |
| A patient must have hypomania for ______ to be diagnosed as having bipolar disorder. | 4 days |
| A patient must have mania for ______ to be diagnosed as having bipolar disorder. | 1 week |
| Associated disorders of bipolar disorder are: | personality disorders, anxiety disorders, anorexia nervosa, bulimia nervosa, and attention deficit hyperactivity disorder. |
| Clinet populatiions with comorbid personality disorders also have a greater tendency toward | medication nonadherence |
| Individuals with _____ may become psychotic or display bizarre behavior and paranoia. | Bipolar I disorder |
| Indiciduals with ______ are more liely to become depressed in winter than in summer, make more suicide attempts, and display disorders in temperment. | Bipolar II disorder |
| People with ______ have a higher lifetime prevalence of anxiety disorder and social and simple phobias, greater disease chronicity,and more subsequent depressions. | bipolar II disorder |
| Bipolar depression is characterized by | higher rates of divorce and marital conflict, affects younger people, produces more episodes of illness, and requires more frequent hospitalization. |
| Bipolar disorders have a strong ____ component | genetic |
| The euphoric mood associated with a bipolar illness is | unstable |
| The irritability and belligerance associated with a bipolar illness may be | short lived, or it may become the prominent feature of a person's manic illness. |
| When a person with bipolar illnes is in a cheerful mood, it may be ________ to the circumstances. | inappropriate |
| In this state, the person often gives away money, prized possessions, and expensive gifts, throws lavish parties, frequents expensive nightclubs and restaurants and spends money freely on friends and strangers alike. | manic state |
| As the clinical course of bipolar disorder progresses, sociability and euphoria are replaced by a stage of | hostility, irritability and paranoia |
| The nonstop physical activity ant the lack of sleep and food when a person is in a manic stage can lead to | physical exhaustion and even death if not treated |
| People often emerge from a _______ state startled and confused by the shambles of their lives. | manic |
| A nearly continuous flow of accelerated speech with abrup changes from topic to topic that are usually based on understandable associations or plays on words. | Fkight of ideas |
| In flight of ideas, the speech is rapid, berbose and circumstantial and the incessant talking often includes | joking, puns and teasing |
| As mania escalates, flight of ideas may give way to | clang associations |
| The stringing together of words because of their rhyming sounds. | clang associations |
| inflated self regard | grandiosity |
| _______ is apparent in both the ideas expressed and the person's behavior. | grandiosity |
| In hypomania, no evidence of ______ or ______ is present. | delusions or hallucinations |
| The client may use humor, manipulation, power struggles, or demanding behavior to prevent or minimize the staff's ability to | set limits on and control dangerous behavior |
| Dividing staff as a ploy to keep the environment unsettled is another unconscious tactic of a _______ client. | manic |
| When the client pits one person or group against another. | Splitting |
| ________ among staff is imperative if the limit setting for a manic patient is to be carried out effectively. | consistency |
| The overall goal during the acute phase of maina is to | prevent injury |
| Outcomes in during the acute phase of mania would be: | hydration, maintain stable cardiac status, maintain/obtain tissue integrity, get sufficient sleep and rest, demonstrate thought self-control, make no attempt at self harm |
| The continuation phase lasts | 4 to 9 months |
| The overall outcome of the continuation phase of treatment is | prevention of relapse |
| The overall outcomes for the maintenance phase of treatment is | to continue to focus on prevention of relapse and to limit the severity and duration of future episodes. |
| Planning during the acute phase focuses on | medically stabilizing the client while maintaining safety. |
| Hospitalization is usually the safest place for the client when | mania is acute |
| Planning during the continuation phase focuses on | maintaining compliance with the medication regimen and precvn=enting relapse. |
| Planning during the maintenance phase focuses on | preventing relapse and limiting the severity and duration of future episodes. |
| Intervention during the acute phase includes: | Hospitalization if necessary, continuously set limits in a firm nonthreatening and neutral manner to prevent further escalation of mania and to provide safe boundaries for the client and others. |
| ______ is effective in the acute treatment of mania and depressive episodes and the prevention of recurrent mania and depressive episodes. | lithium carbonate |
| Once primary acute mania has been diagnosed, _____ is most often the first choice of treatment. | lithium |
| Some subgroups of bipolar clients may not respond well to lithium but may do well when treated with | antiepileptic drugs (AED's) |
| Anxiolytics are useful in the treatment of ______ in some clients with treatment-resistent mania. | acute mania |
| _______ seem to have mood stabilizing properties. | Antipsychotics |
| In clients with treatment-resistent mania and rapid cycling, ______ is used to subdue severe manic behavior. | Electoconvulsive Therapy (ECT) |
| The _______ provides comfort and relief to many clients who can do longer control their own behavior. | seclusion room |
| The nurse documents the following for a client in seclusion: | Behavior leading up to the seclusion or restraint. Actions taken to provide least restrictive alternative. Time placed in seclusion, Q15 min behavior, needs care, and vital signs. Tim and type of medications administered and their effects on the client. |
| ____ and _____ are never to be used as punishment or for the convenience of the staff. | restraints and seclusion |
| The outcome for the treatment continuation phase is to | prevent relapse |
| _____ ______ during the treatment continuation phase is perhaps the most important treatment outcome. | medication compliance |
| Why are changes in sleep pattern especially important for families of bipolar patients to notice? | Because they usually predede, accompany, or precipitate mania. |
| _____ is typically used as an adjunct to pharmacotherapy in treating bipolar disorders. | CBT |
| ______ is an important treatment in bipolar illness; it results in greater compliance with the lithium regimen. | psychotherapy |
| A major principle that should be observed when a nurse communicates wit a client experience elated mood is to | use a calm, firm approach |
| A medication teaching plan for a client receiving lithium should include periodic monitoring of | renal and thyroid function |
| Verbosity is a symptom present in a _______ client and is specific to communication. | manic |
| For assessment purposes, the nurse should identify the body system most at risk for decompensation duing a sever manic episode as | cardiac |
| A person who has numerous hypomanic and dysthymic episodes can be assessed as having | cyclothymia |
| Exaggerated belief in one's own importance, identity, or capabilities, is seen with | grandiosity |
| A bipolar client tells the nurse "I have the finest tenor voice in the world. The three tenors who do all those TV concerts are going to retire because they can't compete with me." The nurse would make the assessment that the client is displaying | grandiosity |
| When a hyperactive manic client attempts to strike another client, the initial nursing intervention should be | verbal limit setting |
| What intervention can the nurse suggest when a client reports that lithium gives him an upset stomach? | take it with meals |
| What action should the nurse take on learning that a manic client's serum lithium level is 1.8 mEq/L? | Withhold medication and notify the physician. Levels should range between 0.4 and 1.3 mEq/L. |
| What side effects of lithium can be expected at therapeutic levels? | Fine hand tremor and polyuria |
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