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Sunday, March 10, 2013

Nursing Care Plan for Bipolar Disorder

Also known as manic-depression is a severe disturbance in affect, manifested by episodes of extreme sadness alternating with episode euphoria. There are two common patterns of bipolar disorder;
bipolar I, in which depressive episode alternate with full manic episodes.
bipolar II, characterized by recurrent depressive episodes and occasional with manic episodes.

Assesment findings for bipolar disorder

    During periods of mania;

  • bizarre and eccentric appereance
  • difficulty concentration, flight of idea, delusion of grandeur and impaired judgment
  • decreased sleep
  • motor agitation
  • feeling of grandiosity
  • rapid jumbled speech
  • deteriorated physical appearance
  • euphoria, hostility
  • dry mouth, tremors, tachycardia, labored respirations
  • inflated sense of self-worth
  • increased social contact
  • increased libido
  • lack of inhibition, recklessness

  • During periods of depression;

  • anorexia and weight loss, constipation
  • altered sleep patterns
  • decreased alertness, difficulty thinking logically
  • confusion and indecisiveness
  • guilt, helplessness, sadness and crying
  • amenorrhea
  • lack of motivation, low self-esteem, poor self-hygiene
  • irritability, pessimism
  • impotence and lack of interest in sex
  • inability to experience pleasure


Treatment for bipolar disorder
  • Anticonvulsant agent : carbamazepine (tegretol), divalproex sodium.
  • Selective serotonin reuptake inhibitor : paroxetine
  • Antimanic agent : lithium carbonate(eskalith), lithium citrate(cibalith-S)
  • Individual therapy and family therapy
  • Electroconvulsive therapy if drug therapy fails
Nursing diagnoses for bipolar disorder
  • Disturbed thought processes
  • Impaired social interaction
  • Risk for injury
  • Disturbed sleep pattern
Planning and goal for bipolar disorder, the client will;
  • demonstrate a stable mood and practice self-care activities
  • control thought processes
  • demonstrate a normal sleep pattern
  • interact adequately with others
  • not harm himself
Nursing implementation for bipolar disorder
    During manic phase;

  • decrease environmental stimuli, to promote relaxation and enable to sleep
  • monitor drug level, especially lithium
  • ensure safe environment to protect the client
  • define and explain acceptable behaviors and then set limits
  • if a mood swing to depression, implement suicide precaution for client
  • channel the client's energy in one direction and pace activities, to decrease client's energy expenditure, prevent overstimulation and have soothing effect

  • During depressive phase;

  • assess the risk of suicide and formulate a safety contract with client
  • assess the level and intensity if client's depression to obtain baseline information
  • ensure a safe environment to client to protect from self-inflicted harm
  • encourage the client to identify current problems and stressors, so that can begin with therapeutic treatment
  • select activities that ensure success and accomplishment to increase self esteem
  • spend time with the client, evens if he's too depressed to talk, in order to enhance therapeutic relationship
  • help the client to modify negative expectations and think more positively
  • promote opportunities for increased involvement in activities through a structures and daily program
  • observe the client for medication compliance and adverse effect
Evaluation for bipolar disorder, the client ;
  • doesn't harm himself or others
  • maintains adequate on medication and nutrition
  • sleeps throught the night
  • expresses understanding of the illness and states how to obtain assistance or support from others
  • engages in goal-directed activity and no longer exhibits disturbed thinking

13 comments:

  1. very info subject it give me what I want :)

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  2. Hello.....It was known as Melancholia in the 17thCentury, Depression is a mood disorder that until now has different forms of treatment and therapy. Even the ancient Greek thought it to be an imbalance of bodily fluids called the humors. Different theories and forms of treatment have already been thought of and administered.See more-depression treatment centers Florida

    ReplyDelete
  3. I really appreciate sharing this great post. Keep up your work.Thanks for sharing this great article.Great information thanks a lot for the detailed article.
    bipolar disorder type

    ReplyDelete
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  5. Am Philo, All thanks to Dr Osaze who cured me of hepatitis B virus, I was almost contemplating death because of the pains i was going through, due to the syppthoms of the virus, until I came across Dr osaze's testimony and recommendations online and I contacted him, and he administered his Haber medicine on me, and within a month and two weeks I bounce back to my normal health status. In case you want to reach him, you can contact him through his email: drosaze39@gmail.com or call him at +2347089275769.


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  6. Portanto, é possível que a doença do HIV possa ser curada porque fui enganada tantas vezes até que me deparei com esse grande homem, Dr. Akhigbe, que me ajudou a princípio, nunca acreditei em todo esse comentário e postei sobre ele e fiquei muito doente porque sofri estiver infectado com HIV / AIDS nos últimos dois anos, apenas nos últimos dois meses eu continuo lendo o testemunho sobre esse homem chamado Dr. Akhigbe, eles disseram que o homem é tão poderoso que ele curou diferentes tipos de doenças, eu continuo monitorando seu post de algumas pessoas sobre esse homem e eu descobri que ele era real, então decidi fazer um teste. Entrei em contato com ele para pedir ajuda e ele disse que me ajudaria a obter minha cura. Tudo o que eu precisava era enviar dinheiro para ele se preparar o medicamento após o qual ele será enviado a mim através dos serviços de entrega da DHL, o que eu fiz para minha maior surpresa, ele me deu instruções para seguir como beber, depois de três semanas eu deveria fazer um check-up, depois de tomar o medicamento e seguir Como ele foi instruído após três semanas, voltei ao hospital para outro teste; no começo, fiquei chocado quando o médico me disse que eu era negativo; peço ao médico que verifique novamente e o resultado ainda era o mesmo negativo que era como do VÍRUS DO HIV, após o choque, eu decidi vir e compartilhar meu próprio testemunho com você para aqueles que pensam que não há cura para o VÍRUS HIV, a cura, como finalmente sair, pare de duvidar e entre em contato com o Dr. Akhigbe via e-mail drrealakhigbe@gmail.com Ele também é perfeito para curar DIABÉTICOS, HERPES, HIV / AIDS, ALS, CÂNCER, HEPATITE AEB, ASMA, DOENÇA CARDÍACA, DOENÇA CRÔNICA. Náusea, vômito ou diarréia, doença renal, picada de aranha, lúpus, infecção externa, resfriado comum, dor nas articulações, epilepsia, acidente vascular cerebral, doença de estômago. ECZEMA, COMENDO O TRANSTORNO etc, acredite em mim que a doença mortal não é mais uma sentença mortal porque o dr akhigbe tem a cura. O padrinho da raiz das ervas.
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    ReplyDelete
  7. Am jeremiah, I am testifying about a great hebal man that cured my wife of hepatitis B, and liver cirhosis. his name is Dr oniha. My wife was diagnose of hepatities two years ago, i almost spent all i had then, until i saw dr oniha recommendation online, and i call him, then he told me how to get the herb. You can also call him on +2347089275769 or email him at dronihaspell@yahoo.com

    ReplyDelete
  8. I am very happy to inform the general public that I am finally cured from Herpes simplex virus recently with the use of herbal medicine, the powerful herbal medicine cured me completely and i was tested negative after usage, I am using this means to inform other's who have the virus that there is a cure for Herpes simplex 1&2 . It is absolutely true. I was cured by Dr Alli, only him I can recognize who cure Herpes perfectly well. I will advice you to contact this great doctor who God has send to put an end to the sorrowful and deadly disease. Contact him via Email  Allispellhelp1@gmail.com or add him on WhatsApp +2348100772528

    ReplyDelete
  9. HOW I GOT CURED OF HERPES DISEASE
    I'm here to testify about what DR. OSO did for me. I have been suffering from (HERPES) disease for the past 5 years and had constant pain,especially inside my body. During the first year,I had faith in God that i would be healed someday. This disease started circulating all over my body and i have been taking treatment from my doctor, few weeks ago i came across a testimony of one lady on the internet testifying about a Man called DR. OSO on how he cured her from herpes disease. And she also gave the email address of this man and advise anybody to contact him for help for any kind of sickness that he would be of help.so I emailed him telling him about my (HERPES) he told me not to worry that i was going to be cured!! Well i never believed it,, well after all the procedures and remedy given to me by this man few weeks later i started experiencing changes all over me as DR. OSO assured me that i will be cured,after some time. i went to my doctor to confirmed if i have be finally healed behold it was TRUE,the test came out negative. So friends my advise is if you have such sickness or any other at all you can contact DR. OSO for help.
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    ReplyDelete


  10. Am jeremiah, I am testifying about a great hebal man that cured my wife of hepatitis B and liver cirhosis. his name is Dr oniha. My wife was diagnose of hepatities two years ago, i almost spent all i had then, until i saw dr oniha recommendation online, and i call him, then he told me how to get the herb. You can call him on +2347089275769 or email him at dronihaspell@yahoo.com

    ReplyDelete
  11. Is any one here suffering from any kind of STD or STI ? , Now this is to everyone out there with different health challenges, as I know there are still a lot of people suffering from different health issues and are therefore looking for solution. I bring you Good news. There is a man called Dr. Tokubo a herbal practitioner who helped cure me from Genital herpes, this i had suffered from for the past 2years and have spent so much money trying to survive from it. I got my healing by taking the herbal medicine he sent to me to drink for about 9days . 3days after completion of the dosage, I went for a medical checkup and I was tested Genital Herpes NEGATIVE. I'm sharing this so that other people can know of this great healer called Dr Tokubo because I got to know him through a friend he cured from HIV. I was made to understand that he can cure several other deadly diseases and infections. Don't die in ignorance and don't let that illness take your life. Contact Dr. Tokubo through: drtokubotemple@gmail.com You can also call/whatsapp him on:+2349037990322 Thank you dr tokubo. Be kind enough to share your testimonies as you received your cure.he is good too to cure all type of disease and virus.1 HIV cure
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    ReplyDelete
  12. Good news to everyone out there with different health challenges, as I know there are still a lot of people suffering from different health issues and are therefore looking for solutions. I bring you Good news. There is a man called Dr James, a herbal practitioner who helped me to cure Hiv virus, i have suffered from this disease for the past 5 years and I have spent so much money trying to survive from it. I got my healing by taking the herbal medicine Dr James sent to me to drink for about 14 days . 3 days after completion of the dosage, I went for a medical checkup and I was tested Hiv negative. all thanks to God for leading me to Dr james who was able to cure me completely from this deadly diseases, I’m sharing this so that other people can know of this great healer called Dr James because I got to know him through Mr Anderson, who he cured from Genital Herpes Virus. I was made to understand that he can cure several other deadly diseases and infections. Don’t die in ignorance or silence and don’t let that illness take your life.Dr James has cures for diseases like BIPOLAR DISORDER,..DIABETES,NEPHROTIC SYNDROME MOUTH HERPES, MOUTH CANCER , MUSCLE ACHES, LUPUS, SKIN CANCER, PENILE CANCER, BREAST CANCER, PANCREATIC CANCER, VAGINAL CANCER, CERVICAL ILLNESS, POLIO DISEASE, ALZHEIMER, BULIMIA DISEASE, COMMON INFLAMMATORY DISEASE CYSTIC FIBROSIS, SCHIZOPHRENIA, CORNEAL ULCER, EPILEPSY, FETAL ALCOHOL SPECTRUM, LICHEN PLANUS, INFERTILITY, SHINGLES, BADRONOLE DISEASE, CHEST DISEASE / AIDS, AND BEHAVIORAL, CHLAMYDIA, ZIKA VIRUS, EMPHYSEMA, TUBERCULOSIS LOW SPERM COUNT, ECZEMA, DRY COUGH, ARTHRITIS Contact Dr James through  email address   Drjamesherbalmix@gmail.com  

    ReplyDelete
  13. THANX TO DOCTOR OSAZE WHO CURE ME FROM HERPES SIMPLEX AND HAERT DIESEASE WITH HIS HERBAL MEDICATION, MY ENTIRE LIFE WAS BECOMING MISERABLE WHEN I CONTACTED THESE DIESEASES, I WENT TO DIFFERENT HOSPITAL IN NEWYORK AND CONNECTICUT TO NO AND VAIL, UNTIL I CAME ACROSS DOCTOR OSAZEE'S TESTIMONIES ONLINE ON HOW HE HAS BEEN USING HIS HERBS TO CURE PEOPLE OF HERPES DIESEASES, AND I DICIDED TO CONTACT HIM AND GIVE HIS MEDICATION A TRY, WITHIN ONE MONTH AND A WEEK I WAS TOTALLY CURED, IN CASE YOU ARE GOING THROUGH SIMILAR PROBLEM AND YOU WANTS TO CONTACT DR OSAZEE, YOU CAN EMAIL HIM ON: DROSAZEHERBAL@GMAIL.COM OR CALL OR WHATSAP HIM ON: +2347089275769

    ReplyDelete