Wednesday, December 9, 2009

Bipolar disorder
Bipolar disorder
Nursing care Plans for Bipolar disorder. Bipolar disorder these disorders are characterized by mood swings from profound depression to extreme euphoria (manic), with intervening periods of normalcy. Some patients suffer from acute attacks of mania only. 

Bipolar I Disorder 
Bipolar I disorder is the diagnosis given to an individual who is experiencing, or has experienced, a full syndrome of manic or mixed symptoms. The client may also have experienced episodes of depression. 

Bipolar II Disorder
Bipolar II disorder is characterized by recurrent bouts of major depression with the episodic occurrence of hypomania. This individual has never experienced a full syndrome of manic or mixed symptoms. 

Cyclothymia Disorder 
A variant of bipolar disorder, numerous episodes of hypomania and depressive symptoms are too mild to meet the criteria for major depression or bipolar illness. The essential feature is a chronic mood disturbance of at least 2 years’ duration, involving numerous periods of depression and hypomania 

Treatment for Bipolar disorder 
Lithium proves highly effective in relieving and preventing manic episodes. But has a narrow therapeutic range, so treatment must be initiated cautiously and the dosage adjusted slowly. The drug curbs the accelerated thought processes and hyperactive behavior without the sedating effect of antipsychotic drugs. In addition, it may prevent the recurrence of depressive episodes; however, it’s ineffective in treating acute depression. 
Valproic acid is an alternative to lithium. Antidepressants occasionally are used to treat depressive symptoms. However, these drugs may trigger a manic episode. 

Nursing diagnosis nursing care Plans for Bipolar disorder 
Common nursing diagnosis found in Nursing care Plans for Bipolar disorder: 
  • Risk for suicide 
  • Chronic low self-esteem 
  • Disturbed personal identity 
  • Disturbed thought processes 
  • Impaired social interaction 
  • Ineffective coping 
  • Ineffective health maintenance 
  • Ineffective role performance 

Nursing interventions nursing care Plans for Bipolar disorder 
Nursing interventions for Bipolar disorder With nursing diagnosis Risk for suicide 
Nursing Diagnosis
Risk for suicide
·     Client will seek out staff when feeling urge to harm self
·     Client will make short-term verbal (or written) contract with nurse not to harm self.
·     Client will not harm self.
·     Client verbalizes no thoughts of suicide.
·     Client commits no acts of self-harm.
·     Client is able to verbalize names of resources outside the hospital from whom he or she may request help if feeling suicidal.
·     Ask client directly: about how when where you will harming yourself? If so, what do you plan to do? Do you have the means to carry out this plan?”
·     Create a safe environment for the client.
·     Remove harmful objects e.g (glass, belts, rope, bobby pins).
·     Supervise his medications.
·     Institute suicide precautions as dictated by facility policy.
·     Formulate a short-term verbal or written contract with the client that he or she will not harm self.
·     Secure promise from client that he or she will seek out a staff member or support person if any thoughts of suicide.
·     Maintain close observation of client. Place in room close to nurse’s station; do not assign to private room
·     Make rounds at, irregular intervals.
·     Encourage verbalizations of honest feelings.  Through exploration and discussion, help client to identify symbols of hope in his or her life.
·     Encourage client to express angry feelings within appropriate limits. Provide safe method of hostility release. Help client to identify true source of anger and to work on adaptive coping skills for use outside the treatment setting.
·     Identify community resources that client may use as support system and from whom he or she may request help if feeling suicidal.
·     Orient client to reality.
·     Spend time with client.

Client will not harm self.

Patient teaching nursing care Plans for Bipolar disorder 

  • Drugs may cause adverse reactions If the patient is taking lithium, teach him and his family to discontinue the drug and notify the physician if signs of toxicity occur, including diarrhea, abdominal cramps, vomiting, unsteadiness, drowsiness, muscle weakness, polyuria, and tremors. 
  • Lithium may impair mental and physical function; caution against driving or operating dangerous equipment while taking the drug. 
  • Teach the patient the importance of continuing his medication regimen even when he doesn’t feel a need for it. 
  • Advise the patient to discontinue medications only with the physician’s approval because abrupt withdrawal could cause severe symptoms.

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