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
Total Self-Care Deficit
May be related to
- Inability to concentrate on one thing at a time.
- Manic excitement.
- Perceptual or cognitive impairment.
- Racing thoughts and poor attention span.
- Severe anxiety.
Possibly evidenced by
- Observation or valid report of inability to eat, bathe, toilet, dress, and/or groom self independently.
- Patient will sleep 6 hours out of 24 with aid of medication and nursing measures within 3 days.
- Patient will eat half to one third of each meal plus one snack between meals with aid of nursing intervention.
- Patient will have normal bowel movements within 2 days with the aid of high-fiber foods, fluids, and, if needed, medication.
- Patient will wear appropriate attire each day while in the hospital.
- Patient will bathe at least every other day while in hospital.
- Patient will sleep 6 to 8 hours per night.
- Patient will have a weight within normal limits for age and height.
- Patient will have bowel habits within normal limits.
- Patient will dress and groom self in appropriate manner consistent with pre-crisis level of dress and grooming.
|Disturbed Sleep Pattern:|
|Keep client in areas of low stimulation.||Promotes relaxation and minimizes manic behavior.|
|Encourage frequent rest periods during the day.||Lack of sleep can lead to exhaustion and death.|
|At night, encourage warm baths, soothing music, and medication when indicated. Avoid giving the client caffeine.||Promotes relaxation, rest, and sleep.|
|Monitor intake, output, and vital signs.||Ensures adequate fluid and caloric intake; minimizes dehydration and cardiac collapse.|
|Frequently remind the client to eat (e.g.,Rob, finish your pancake”, “Sandra, drink this apple juice.”).||The manic client is unaware of bodily needs and is easily distracted. Needs supervision to eat.|
|Encourage frequent high-calorie protein drinks and finger foods (e.g., sandwiches, fruit, milkshakes).||Constant fluid and calorie replacement are needed. Client might be too active to sit at meals. Fingers foods allow “eating on the run”.|
|Monitor bowel habits; offer fluids and foods rich in fiber. Evaluate the need for a laxative. Encourage client to go to the bathroom.||Prevents fecal impaction resulting from dehydration and decreased peristalsis.|
|Dressing/Grooming Self-Care Deficit:|
|If warranted, supervise choice of clothes; minimize flamboyant and bizarre dress, and sexually suggestive dress, such as bikini tops and bottoms.||Lessens the potential for inappropriate attention, which can increase the level of mania, or ridicule, which lowers self-esteem and increases the need for manic defense. Assists client in maintaining dignity.|
|Give simple step-by-step reminders for hygiene and dress (e.g.,”Here is your toothbrush. Put the toothpaste on the brush”).||Distractability and poor concentration are countered by simple, concrete instructions.|
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Mental Health and Psychiatric Care Plans
Care plans about mental health and psychiatric nursing: