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
Impaired Social Interaction
- Impaired Social Interaction
May be related to
- Biochemical imbalances.
- Disturbed thought processes.
- Excessive hyperactivity and agitation.
Possibly evidenced by
- Dysfunctional interaction with family, peers, and/or others.
- Family reports a change of style or patterns of interaction.
- Inability to develop satisfying relationships
- Increase of manic behaviors when the client is in a highly stimulating environment (e.g., with groups of people, bright lights, loud music).
- Intrusive and manipulative behaviors antagonizing others.
- Loud, obscene, or threatening verbal behavior.
- Observed use of unsuccessful social interaction behaviors.
- Poor attention span and difficulty focusing on one thing at a time.
- Patient will initiate and maintains goal-directed and mutually satisfying activities/verbal exchanges with others.
- Patient will find one or two solitary activities that can help relieve tensions and minimize escalation of anxiety with aid of nurse or occupational/activity therapist.
- Patient will focus on one activity requiring a short attention span for 5 minutes three times a day with nursing assistance.
- Patient will sit through a short, small group meeting free from disruptive outbursts.
- Patient will demonstrate an ability to remove self from a stimulating environment in order to “cool down” by discharge.
- Patient will participate in unit activities without disruption or demonstrating inappropriate behavior by discharge.
- Patient will put feelings into words instead of actions when experiencing anxiety or loss of control before discharge.
|When less manic, the client might join one or two other clients in quiet, nonstimulating activities (e.g., drawing, board games, cards).||As mania subsides, involvement in activities that provide a focus and social contact becomes more appropriate. Competitive games can stimulate aggression and can increase psychomotor activity.|
|When possible, provide an environment with minimum stimuli (e.g., quiet, soft music, dim lighting).||Reduction in stimuli lessens distractability.|
|Solitary activities requiring short attention spans with mild physical exertion are best initially (e.g., writing, taking photos, painting, or walks with staff).||Solitary activities minimize stimuli; mild physical activities release tension constructively.|
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Mental Health and Psychiatric Care Plans
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