Bipolar disorders are mood disorders that comprise of one or more manic or hypomanic episode and usually one or more depressive episodes with periods of relatively normal functioning in between. They are said to be linked to biochemical imbalances in the brain and it is said that the disease is genetically transferred.
Nursing Care Plans
Clients with bipolar disorders are at a high risk for suicide. Although clients in the manic phase are briefly agitated, energized and elated, their underlying depression makes them likely to inflict self-injury.
Essential responsibilities of nurses are to provide a safe environment, to improve the self-esteem, to meet the physiologic needs and to guide patients toward socially appropriate behavior.
- Risk For Injury
- Risk For Violence: Self-Directed or Other Directed
- Impaired Social Interaction
- Ineffective Individual Coping
- Interrupted Family Processes
- Total Self-Care Deficit
Risk For Injury
- Risk for Injury
- Affective, cognitive, and psychomotor factors.
- Biochemical/neurologic imbalances.
- Exhaustion and dehydration.
- Extreme hyperactivity/physical agitation.
- Rage reaction.
Possibly evidenced by
- Abrasions, bruises, cuts from running/falling into objects.
- Extreme hyperactivity.
- Impaired judgment (reality-testing, risk behavior).
- Lack of fluid ingestion.
- Lack of control over purposeless and potentially injurious movements.
- Patient will respond to the medication within the therapeutic levels.
- Patient will sustain optimum health through medication management and therapeutic regimen.
- Patient will have stable cardiac status while in the hospital.
- Patient will drink 8 oz of fluid every hour throughout the day while on acutely manic stage.
- Patient will remain free from falls and abrasions every day while in the hospital.
- Patient will be free of dangerous levels of hyperactive motor behavior with the aid of medications and nursing interventions within the first 24 hours.
- Patient will spend time with the nurse in a quiet environment three to four times a day between 7 am and 11 pm with the aid of nursing guidance.
- Patient will take short voluntary rest periods during the day.
- Patient will be free of excessive physical agitation and purposeless motor activity within 2 weeks.
- Patient will be free of injury within 2 to 3 weeks:
- Stable cardiac status.
- Skin free of abrasions and scrapes.
- Well dehydrated.
|Provide structured solitary activities with the assistance of a nurse or aide.||Structure provides focus and security.|
|Provide frequent rest periods.||Prevents exhaustion.|
|Provide frequent high-calorie fluids (e.g., fruit shake, milk).||Prevents the risk of serious dehydration.|
|Maintain a low level of stimuli in client’s environment (e.g., loud noises, bright light, low-temperature ventilation).||Helps minimize escalation of anxiety.|
|Acute mania might warrant the use of phenothiazines and seclusions to decrease any physical harm.||Exhaustion and death result from dehydration, lack of sleep, and constant physical activity.|
|Observe for signs of lithium toxicity (e.g., nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, lack of coordination, blurred vision, or ringing in your ears).||There is a small margin of safety between therapeutic and toxic doses.|
|Protect client from giving away money and possessions. Hold valuables in a hospital safe until rational judgment returns.||Client’s “generosity” is a manic defense that is consistent with irrational, grandiose thinking.|
|Redirect violent behavior.||Physical exercise can decrease tension and provide focus.|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other care plans for mental health and psychiatric nursing:
- Alcohol Withdrawal | 5 Care Plans
- Anxiety and Panic Disorders | 7 Care Plans
- Bipolar Disorders | 6 Care Plans
- Major Depression | 9 Care Plans
- Personality Disorders | 4 Care Plans
- Schizophrenia | 6 Care Plans
- Sexual Assault | 1 Care Plan
- Substance Dependence and Abuse | 8 Care Plans
- Suicide Behaviors | 3 Care Plans