What are the nursing interventions for bipolar disorder?

Nursing Care for Bipolar Disorder Singapore

Overview

Bipolar disorder is a psychiatric condition in which the patient experiences mood swings specifically episode of happiness and sadness. Happiness or mania may produce extreme pleasure to bipolar patients while sadness or depression may lead to hopeless or disinterests to certain daily activities. This psyche problem can occur frequently and may require treatment. But proper clinical diagnosis is important prior to medical treatment.

Types and Symptoms

According to DSM-5 or the holy bible of the psychiatrists, there are specific types and criteria for bipolar disorder. The main types or class are Bipolar I disorder, Bipolar II disorder and Cyclothymic disorder. If there is one episode of euphoria or mania, then it is classified as Bipolar I disorder. If there is an episode of sadness for minimum of 2 weeks and a hypomania episode for four days, then it is a sign of Bipolar II disorder. Lastly, if there are manic and depressive symptoms for two years, then it is a cyclothymic disorder.

Additional med ical symptoms of bipolar disorder may inc lude the following: psychosis, anxiety, catatonia, mood swing episodes to name a few. Immediate hospitalization is required if they are a threat to others and to their own self as well.

Online health journals and resources attribute this condition to inherited gene or genome among men and women. Moreover, abnormality in production of neurotransmitters also determines the outcome of this disorder.

Nursing Care Plan

The nurse can implement a nursing care plan suitable for a patient with this condition. Usually patients who are at man ic episodes are at risk for violence with other people. So first, the nurse should provide a safe environment. Nurses should remove harmful and sharp objects that are destructive to others. The nur sing staff can also encourage the client to practice vent out his or her feelings to lessen the anxiety. Lastly, drugs such as Librium can be use to control the mood of the patient. Nurses can also refer the patient to a psychiatrist who can perform various types of mental treatment such as CBT (cognitive behavioral therapy), IPRST (interpersonal and social rhythm therapy, psychotherapy or psych o education. Other forms of treatment may be through ECT or electroconvulsive therapy and TMS or transcranial magnetic stimulation.

Conclusion

Bipolar is manageable if there is proper diagnosis and treatment regimen. For nurses caring for them, they must provide excellent service and pract ice patience. News, online article, new database, and other alt map data about bipolar disorders are available online and can be accessed at home.

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Diagnosis Bipolar Disorder: "Bipolar disorder is a severe biologic illness characterized by recurrent fluctuations in mood. Typically, patients experience alternating episodes in which mood is abnormally elevated or abnormally depressed-separated by periods in which mood is relatively normal." (Lehne, 2004, p. 321)

The following is a short synopsis according to the DSM-IV-TR, "Criteria for Bipolar Disorder" includes a distinct period of abnormality and persistently elevated, expansive, or irritable mood for at least:
- 4 days for hypomania
- week for mania

During the period of mood disturbance, at least three or more of the following symptoms have persisted and have been present to a significant degree:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative than usual or pressure to keep talking
- Excessive involvement in pleasurable activities that have a high potential for painful consequences.
(American Psychiatric Association [APA], 2000).

Psychodynamics of the Disease The onset of the disease usually occurs during late adolescence or in the mid twenties. However, the disease has been known to occur up into the fifth decade of life. The mood swings that accompany this disorder are of several types. They are as follows: the Pure Manic Episode, evidenced by hyperactivity, excessive enthusiasm, and flight of ideas, constant wakefulness without sleep,

Impairment in normal social functioning usually requiring hospitalization; Hypomanic Episode, evidenced by a milder form of the Pure Mania, without the loss of normal functioning that would require hospitalization; Major Depressive Episode, characterized by depressed mood consisting of symptoms such as anhedonia, avolition, alogia, affective flattening and thoughts of suicide and death; the last episode associated with Bipolar disorders is the Mixed Episode in which, patients experience symptoms of mania and depression simultaneously. The combination of high energy and depression puts them at significant risk of suicide. (Lehne, 2004, p. 321)

Case Presentation
A Caucasian woman in her mid twenties presented signs and symptoms of self mutilation with a straight edge razor inflicted gash across her lower abdomen approximately six inches below the umbilicus. The depth of the gash just stopped at the abdominal fascia. The patient was sent from the emergency room to the psychiatric floor. Upon meeting the patient one day after her admission to E.R., she appeared dressed in pajama bottoms and a t-shirt, shuffling down the hall in her socks. She was holding her abdomen with one hand and appeared in some discomfort. Her black hair was short and disheveled. When the patient arrived at her room she sat down on her bed.

She acknowledged with blunted affect that she cannot stop self mutilation, and described how she cut herself through the muscles in her abdomen almost down to the fascia. Her voice was tremulous and fast paced. This could be due to the fact that she had just been given her first dose of Clozaril. She stated that her mouth was dry and that she needed to drink some water. She then went on to say that she was getting very sleepy. The client felt comfortable with the interview.

She shared personal information in regards to being sexually abused by her bother beginning at the age of seven until the age of fifteen. Her brother was two years older than her and died in an automobile accident at the age of eighteen. She went on to say that her mother never knew or acknowledged the sexual abuse and that she could not tell her because the mother idolized the son. The client was receptive to cognitive reframing; however she was very critical of herself and stated that she felt worthless and ashamed. She appeared very tired and stated that she wanted to sleep.

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