NUR 114 Final Exam (All Possible
Questions Accurately Answers)
Bipolar I disorder characterized by correct answers at least one week long manic episode
that results in excessive activity. Mostly mania with mix of depression
Mania can be correct answers euphoric or dysphoric
Bipolar II disorder correct answers mostly depression and hypomania. Early ages of 20 and
60 years old. Not severe enough to impair social/occupational life.
Cyclothymic disorder correct answers 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 correct answers among females
More than half the people with bipolar disorder have correct answers have another
psychiatric disorder, most being panic attacks, social phobia, etc.
Bipolar disorders have a strong correct answers heritability
Diathesis stress model correct answers genetic predisposition or chemical imbalance may
never experience symptoms, until an event triggers the disorder.
1
,Bipolar disorder may be more common in correct answers upper socioeconomic classes
For Bipolar, Early diagnosis and treatment is key in correct answers preventing suicide
attempts, alcohol/substance abuse, marital/work problems, etc.
Mania characteristics correct answers ○ 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 correct answers a danger to self or others
With people with mania, nurses need to correct answers SET LIMITS! Consistency is key
among staff if limit setting is to be carried out consistently.
Big diagnosis for mania is correct answers RISK FOR INJURY
Acute phase correct answers primary outcome is injury prevention- stabilizing the patient
(hydrating, maintaining cardiac status, getting enough sleep and rest)
Continuation phase correct answers focuses on adhering to the medication regimen and
preventing relapse
Maintenance therapy correct answers focuses on relapse prevention and limitation of
further episodes
Meds to use during acute phase correct answers use Lithium and Lamictal are the first line
of treatment for someone with bipolar disorder
2
,Lithium correct answers 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 correct answers effective at diminishing impulsive and aggressive
behaviors in pts who are not psychotic- Valproate (Depakote)- monitor liver function and
platelet count
Antianxiety drugs correct answers should be avoided in patients with h/o substance abuse.
Clonazepam (Klonopin) and Lorazepam (Ativan)
ECT correct answers 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 correct answers NEVER TO BE USED AS PUNISHMENT
If a patient is secluded correct answers check every 15 minutes, offer food and fluids every
30 minutes
Major depressive disorder correct answers 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
3
, Terminal insomnia (early morning awakening) correct answers is a red flag for depression
Disruptive mood dysregulation disorder correct answers in children b/w the ages of 6 and
18- frequent temper tantrums resulting in verbal or behavioral outbursts.
Dysthymic disorders correct answers feelings of depression consistently for at least 2
years
Premenstrual dysphoric disorder correct answers 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 correct answers Parkinson's,
kidney failure, etc.
If depression occurs in childhood or adolescence correct answers recurrence is high
Cognitive theory correct answers people who have positive thoughts will experience positive
emotions, people who have negative thoughts will experience negative emotions
Learned helplessness correct answers 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 correct answers sleep, regulates appetite, sex drive
Norepinephrine correct answers attention and behavior
Anergia correct answers lack of physical energy
Psychomotor agitation correct answers pacing or wringing of hands
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