Diagnosis Bpd: "Bipolar disorder is a serious biologic illness characterized while recurrent fluctuations in mood. Typically, patients experience alternating episodes in which mood is abnormally elevated or abnormally depressed-separated by periods because of mood is relatively traditional. " (Lehne, 2004, f. 321)
The following is a short synopsis according to the DSM-IV-TR, "Criteria for Bipolar Disorder" has a distinct period of problem and persistently elevated, conglomeration, or irritable mood for a minimum of:
- 4 days that suit hypomania
- week for mania
During the period of mood disturbance, at least three or fantastic find for any following symptoms have persisted and present to a serious degree:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative than normal or pressure to keep talking
- Excessive curiosity about pleasurable activities in a high potential for tough consequences. " (American Psychiatric Association [APA], 2000).
Psychodynamics from the Disease The onset within the disease usually occurs during late adolescence or in the mid twenties. However, the disease has existed to occur up for your fifth decade of your life. The mood swings that accompany this disorder are of many types. They are the next: the Pure Manic Cholera outbreak, evidenced by hyperactivity, impressive enthusiasm, and flight of course ideas, constant wakefulness toward sleep,
Impairment in ordinary social functioning usually necessitating hospitalization; Hypomanic Episode, evidenced by milder form of the only real Pure Mania, without shedding off normal functioning that will need hospitalization; Major Depressive Instance, characterized by depressed mood involving symptoms such as anhedonia, avolition, alogia, affective flattening and thoughts of suicide and death; the last episode associated with Bipolar disorders is your Mixed Episode in to be, "patients experience symptoms of those mania and depression within. The combination of upbeat and depression puts them at significant possibility of suicide. " (Lehne, 2004, f. 321)
Case Presentation
A Caucasian woman in her own mid twenties presented indication of self mutilation with an even edge razor inflicted gash much more than her lower abdomen approximately six inches underneath the umbilicus. The depth from the gash just stopped for abdominal fascia. The patient collected from the emergency room on the other hand psychiatric floor. Upon meeting one more one day after her use of E. R., she appeared presenting pajama bottoms and lots of t-shirt, shuffling down the hall in her own socks. She was holding her or him abdomen with one hand and grown to some discomfort. Her white hair was short also disheveled. When the patient achieved her room she sat down on her bed. She acknowledged with blunted affect jane cannot stop self mutilation, and described how she cut herself about muscles in her abdomen almost as per the fascia. Her voice was tremulous and frenzied. This could be because the that she had just been given her first small Clozaril. She stated that your mouth was dry which she needed to drink some water. She then went against say that she actually was getting very sleepy. Customer felt comfortable with the job interview.
She shared personal information such as being sexually abused at the bottom of her bother beginning at what age seven until the the age of fifteen. Her brother was 2 yrs older than her and died in an injury at the age related to the eighteen. She went against say that her mother never knew or acknowledged the sexual abuse which generally she could not tell her as being mother idolized the male. The client was concious of cognitive reframing; however she was extremely critical of herself and stated that she felt worthless extremely ashamed. She appeared very tired and stated that she wanted to sleep.
Table 1
Textbook characteristics of Bpd versus client characteristics observed
Textbook Has a:
Pure Manic Episode
Hypomanic Episode
Major Depressive Episode-
Affective Flattening
Alogia
Avolition-apathy
Anhedonia
Mixed Episode
Rapid-Cycling The illness Disorder- Patients experience about four or Client
Characteristics Observed:
No present day symptoms
Rapid breathing, rapid foreign language, however due to medication litigant was concurrently exhibiting lethargy
Client approved sadness/ worthlessness
Facial expression flat
Thoughts men and women dying, hard to focus
Hair/clothes unkempt
Expressed no concern in children or own
Client's Symptoms
1. Hypomania
2. Depression
a. ) Efficient Flattening
b. ) Alogia
c. ) Avolition & Apathy
d. ) Anhedonia
3. In conjunction with Episode
4. Rapid Cycling
(Varcarolis, 2004, f. 485)
Nursing Interventions
1. Observe the client every 15 minutes then when suicidal, remove all risky, sharp objects from location.
2. Reinforce that they have worth while,
a. ) Assist the visitors in evaluating the positive as well as the negative aspects of thes life
b. ) Encourage a suitable expression of angry opinion.
c. ) Schedule regular cycles throughout the day as for recreational/occupational therapy, encourage big event to groom self, donate praise for completing grooming.
d. ) Ensure customer's participation in taking self-control stabilizing medications. Watch big event swallow medication.
3. Lease client in interpersonal natural treatments, cognitive-behavioral therapy,
4. Encourage client to wait group therapy, and ledger episodes.
Table 2
Medical Surgery, Bipolar Disorder
Drug therapy using
Mood stabilizer
Antidepressants
Antipsychotics
Education to see Psychotherapy
ECT
(Varcarolis, 2002, p. 483)
Clients Medical Interventions
Drug therapy includes
Lithium 300mg just about any h. s.
Not taking any Clozaril
Client can psychotherapy, family counseling, group therapy whilst hospital, and cognitive repairing.
None
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