mood disorders chapter 12 and 13. what is bipolar disorder? (bipolar #1) diagnosing and treating...
TRANSCRIPT
![Page 1: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/1.jpg)
Mood Disorders
chapter 12 and 13
![Page 2: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/2.jpg)
• What is Bipolar Disorder? (Bipolar #1)• http://www.youtube.com/watch?v=MBUOoQk0hhU • Diagnosing and Treating Bipolar Disorder (Bipolar #2)• http://www.youtube.com/watch?v=iMMDYZdJBeM• What is Depression? (Depression #1)• http://www.youtube.com/watch?v=IeZCmqePLzM• Treating Depression (Depression #2)• http://www.youtube.com/watch?v=qVEueGutbSs • Clinical Depression• http://www.youtube.com/watch?v=-bru3sJ8yiU
![Page 3: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/3.jpg)
Mood Disorders
• Depression is the oldest and most frequently described psychiatric illness.
• Transient symptoms are normal, healthy responses to everyday disappointments in life.
• Pathological depression occurs when adaptation is ineffective.
![Page 4: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/4.jpg)
Types of Mood Disorders
• Depressive Disorders
• Bipolar Disorders
• Others
![Page 5: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/5.jpg)
Depressive Disorders
• Major Depressive Disorder• Dysthymic Disorder• Premenstrual Dysphoric Disorder• Bipolar Disorders
Other Mood Disorders• Mood disorder due to a general medical condition
• Substance-induced mood disorder
![Page 6: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/6.jpg)
Bipolar Disorders
• Bipolar I Disorder• Bipolar II Disorder• Cyclothymic Disorder
![Page 7: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/7.jpg)
Depression: Predisposing Factors• Biological theories
– Genetics:– Biochemical influences: Neuroendocrine theoriesPhysiological influences– Psychoanalytical theory
• Mourning • Melancholia
Learning theoryObject lossCognitive theory
![Page 8: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/8.jpg)
Depression: Developmental Implications
Childhood Depression• Symptoms:
Adolescence• Symptoms include:• Senescence
Treatment
• Postpartum Depression Treatment
![Page 9: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/9.jpg)
Assessment
• Transient depression• Mild depression• Moderate depression • Severe depression
![Page 10: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/10.jpg)
Nursing Diagnosis
![Page 11: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/11.jpg)
Outcome
![Page 12: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/12.jpg)
Planning/Implementation
![Page 13: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/13.jpg)
Client/Family Education
![Page 14: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/14.jpg)
Evaluation
![Page 15: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/15.jpg)
Treatment Modalities
![Page 16: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/16.jpg)
Antidepressants
Newer-generation antidepressants– Selective serotonin reuptake inhibitors (SSRIs)– Second- and third-generation antidepressants
• Tricyclic antidepressants• Monoamine oxidase inhibitors (MAOIs)
![Page 17: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/17.jpg)
![Page 18: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/18.jpg)
Contraindications/precautions
• Contraindications/precautions– Contraindicated in known hypersensitivity (SSRIs,
MAOIs, tricyclics); acute phase of recovery from myocardial infarction; angle-closure glaucoma (tricyclics); and concomitant with MAOIs (SSRIs and tricyclics).
– Caution with elderly or debilitated clients; clients with hepatic, cardiac, or renal insufficiency; psychotic clients; clients with benign prostatic hypertrophy; and those with history of seizures (tricyclics, MAOIs).
![Page 19: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/19.jpg)
Antidepressants- SSRI
• GenericFluoxetineParoxetineSertralineCitalopramEscitalopramFluvoxamine
• BrandProzacPaxilZoloftCelexaLexaproLuvox
![Page 20: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/20.jpg)
Serotonin Syndrome
• Delirium Agitation• Tachycardia Sweating• Hyperreflexia Muscle spasms• Shivering Coarse tremors More severe cases• Hyperthermia Seizures• Renal failure Rhabdomyolysis• Dysrhythmias DIC
![Page 21: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/21.jpg)
Antidepressants
• Generic Bupropion Mirtzapine Venlafaxine Duloxetine Amitriptyline Imipramine Phenelzine Selegiline
• Brand Wellbutrin Remeron Effexor Cymbalta Elavil Tofranil Nardil Emsam
![Page 22: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/22.jpg)
Monoamine Oxidase Inhibitor
• Nardil• Parnate• Marplan • Selegiline**Available in a patch form called EMSAM
Hypertensive Crisis and Tyramine
![Page 23: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/23.jpg)
Bipolar Disorder (Mania)
AssessmentStage I—HypomaniaStage II—Acute maniaStage III—Delirious mania
![Page 24: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/24.jpg)
Bipolar Disorder (Mania)
Childhood and Adolescence• Lifetime prevalence of pediatric and
adolescent bipolar disorders is estimated at about 1 percent
• Diagnosis is difficult• Guidelines for diagnosis and treatment have
been developed by the Child and Adolescent Bipolar Foundation (CABF)
![Page 25: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/25.jpg)
Nursing Diagnosis
![Page 26: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/26.jpg)
Outcomes
![Page 27: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/27.jpg)
Planning/Implementation
![Page 28: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/28.jpg)
Client/Family Education
![Page 29: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/29.jpg)
Evaluation
![Page 30: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/30.jpg)
Psychopharmacology/Mood Stabilzers
• GenericLithumValproic acidCarbamazepine OxcarbazepineLamotrigineTopiramate
• BrandEskalith, LithobidDepakote, DepakeneTegretol, EquetroTrileptalLamictalTopamax
![Page 31: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/31.jpg)
Planning/Implementation• Blood levels are needed
for Lithium (0.4-1.2mEg/ml)
Depakote (4-12 mEg/ml)
Tegretol (4-12 meg/ml)
• Monitor for side effects of lithium– Drowsiness, dizziness,
headache– Dry mouth; thirst; GI upset;
nausea/vomiting– Fine hand tremors– Hypotension; arrhythmias,
pulse irregularities– Polyuria; dehydration– Weight gain--Potential for toxicitySymbyax is a combination of
Prozac an antidepressant and Zyprexa an atypical major tranquilizer.
![Page 32: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/32.jpg)
Monitor for side effects of anticonvulsants– Nausea and vomiting– Drowsiness; dizziness– Blood dyscrasias– Prolonged bleeding time (with valproic acid)– Risk of severe rash (with lamotrigine)– Decreased efficacy with oral contraceptives (with
topiramate
![Page 33: Mood Disorders chapter 12 and 13. What is Bipolar Disorder? (Bipolar #1) Diagnosing and Treating Bipolar Disorder](https://reader035.vdocuments.site/reader035/viewer/2022062421/56649e385503460f94b29926/html5/thumbnails/33.jpg)
Planning/Implementation (cont.)• Educate client and family about the
medication
Outcome Criteria/Evaluation