NUR 114 Final Exam Prep Questions and Correct Answers
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Course
NUR 114
Institution
NUR 114
Bipolar I disorder characterized by at least one week long manic episode that results in excessive activity. Mostly mania with mix of depression
Mania can be euphoric or dysphoric
Bipolar II disorder mostly depression and hypomania. Early ages of 20 and 60 years old. Not severe enough to impair s...
NUR 114 Final Exam Prep Questions and
Correct Answers
Bipolar I disorder characterized by ✅at least one week long manic episode that results
in excessive activity. Mostly mania with mix of depression
Mania can be ✅euphoric or dysphoric
Bipolar II disorder ✅mostly depression and hypomania. Early ages of 20 and 60 years
old. Not severe enough to impair social/occupational life.
Cyclothymic disorder ✅cycle in and out of hypomania (no delusions and
hallucinations) and depression. Two years for an adult, 1 year for a child
Bipolar II disorders are more common ✅among females
More than half the people with bipolar disorder have ✅have another psychiatric
disorder, most being panic attacks, social phobia, etc.
Bipolar disorders have a strong ✅heritability
Diathesis stress model ✅genetic predisposition or chemical imbalance may never
experience symptoms, until an event triggers the disorder.
Bipolar disorder may be more common in ✅upper socioeconomic classes
For Bipolar, Early diagnosis and treatment is key in ✅preventing suicide attempts,
alcohol/substance abuse, marital/work problems, etc.
Mania characteristics ✅○ Mood - highly unstable. May laugh or joke or speak in a
continuous stream. Mood can quickly change to irritation or anger. Patients have high
self confidence and know no strangers. Excessive spending, elaborate schemes.
○ Behavior- constant activity and reduced need for sleep prevent proper rest. Non stop
physical activity can lead to physical exhaustion and death if not treated; this is an
EMERGENCY! Act on impulses.
○ Thought processes and speech patterns- flight of ideas is continuous flow of
accelerated speech- change in topic and plays on word. Speech is usually loud, vulgar
and sexua. Clang associations are stringing words together based on their rhyming
sounds.
For Mania, Always assess if the patient is ✅a danger to self or others
,With people with mania, nurses need to ✅SET LIMITS! Consistency is key among staff
if limit setting is to be carried out consistently.
Big diagnosis for mania is ✅RISK FOR INJURY
Acute phase ✅primary outcome is injury prevention- stabilizing the patient (hydrating,
maintaining cardiac status, getting enough sleep and rest)
Continuation phase ✅focuses on adhering to the medication regimen and preventing
relapse
Maintenance therapy ✅focuses on relapse prevention and limitation of further
episodes
Meds to use during acute phase ✅use Lithium and Lamictal are the first line of
treatment for someone with bipolar disorder
Lithium ✅naturally occurring salt in the body- effective in tx of bipolar I disorder- start
low and go slow- takes about 10-21 days to be effective- must reach therapeutic level to
be effective (7-14 days)- 0.4-1.3 mEq/L-levels should not exceed 1.5 (considered toxic)-
Should be taken 5 days after beginning lithium therapy- after therapeutic levels are
reached, check every month- after 6 months of stability, levels should be checked every
3 months. Risks are hypothyroidism and impairment of the kidneys. Be sure patients
know they need to continually take medication. IF DIARRHEA, VOMITING OR
SWEATING OCCURS STOP LITHIUM AND CONTACT YOUR PHYSICIAN. Take with
meal, do not take with diuretics.
Anticonvulsant drugs ✅effective at diminishing impulsive and aggressive behaviors in
pts who are not psychotic- Valproate (Depakote)- monitor liver function and platelet
count
Antianxiety drugs ✅should be avoided in patients with h/o substance abuse.
Clonazepam (Klonopin) and Lorazepam (Ativan)
ECT ✅can be used to subdue manic behavior and severe depression- side effect is
memory loss
induces a seizure - patient will complain about a h/a, and may be confused or
disoriented for several hours.
SECLUSION AND RESTRAINTS ARE ✅NEVER TO BE USED AS PUNISHMENT
If a patient is secluded ✅check every 15 minutes, offer food and fluids every 30
minutes
, Major depressive disorder ✅persistent depressed mood lasting longer than 2 weeks
○ Accompanied by a lack of interest in previous pleasurable activity (anhedonia),
fatigue, sleep disturbances, changes in appetite, feelings of hopelessness or
worthlessness.
○ Complain of problems with family and friends, inability to concentrate and make
decisions, psychomotor agitation (restless, fidgety, wringing of hands). Can be
preoccupied with death
Terminal insomnia (early morning awakening) ✅is a red flag for depression
Disruptive mood dysregulation disorder ✅in children b/w the ages of 6 and 18-
frequent temper tantrums resulting in verbal or behavioral outbursts.
Dysthymic disorders ✅feelings of depression consistently for at least 2 years
Premenstrual dysphoric disorder ✅occurs during week prior to menstrual cycle- sx
similar to major depression and interfere with person's life.
Depressive disorder associate with another medical condition ✅Parkinson's, kidney
failure, etc.
If depression occurs in childhood or adolescence ✅recurrence is high
Cognitive theory ✅people who have positive thoughts will experience positive
emotions, people who have negative thoughts will experience negative emotions
Learned helplessness ✅a person believes that when something bad happens it is
his/her fault and nothing at all can be done to change it! Common in the ELDERLY
Serotonin ✅sleep, regulates appetite, sex drive
Norepinephrine ✅attention and behavior
Anergia ✅lack of physical energy
Psychomotor agitation ✅pacing or wringing of hands
Psychomotor retardation ✅slowed movements
Somatic complaints ✅h/a, malaise, backaches
Vegetative signs of depression ✅changes in BM, eating habits, sleep disturbance and
disinterest in sex.
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