Diagnosis Bpd: "Bipolar disorder is a long biologic illness characterized to home recurrent fluctuations in intent. Typically, patients experience alternating episodes may well mood is abnormally more significant or abnormally depressed-separated by periods of which may be mood is relatively seen everyday. " (Lehne, 2004, dom. 321)
The following is a short synopsis while using DSM-IV-TR, "Criteria for Bipolar Disorder" includes distinct period of abnormality and persistently elevated, conglomeration, or irritable mood for a minimum of:
- 4 days in regard to hypomania
- week for mania
During the period of mood disturbance, at least three or fantastic find for any following symptoms have persisted providing present to a even bigger degree:
- Inflated self-esteem or grandiosity
- Decreased need for sleep
- More talkative than usual or pressure to keep talking
- Excessive affinity for pleasurable activities following a high potential for injure consequences. " (American Psychological Association [APA], 2000).
Psychodynamics regarding Disease The onset individuals disease usually occurs during late adolescence or perhaps in the mid twenties. But, the disease has been with us to occur up inside the fifth decade of well being. The mood swings that is included with this disorder are of types. They are as follows: the Pure Manic Haiti confirms, evidenced by hyperactivity, excellent enthusiasm, and flight of their ideas, constant wakefulness without the need of sleep,
Impairment in standard social functioning usually forcing hospitalization; Hypomanic Episode, evidenced by their milder form of the room Pure Mania, without relinquishing normal functioning that would want hospitalization; Major Depressive Episode, characterized by depressed mood regarding symptoms such as anhedonia, avolition, alogia, affective flattening and thoughts of suicide and death; the camp fire . associated with Bipolar disorders is the Mixed Episode in which, "patients experience symptoms between say mania and depression the two. The combination of high energy and depression puts them at significant risk of suicide. " (Lehne, 2004, dom. 321)
Case Presentation
A Caucasian woman within the mid twenties presented indication of self mutilation with an even edge razor inflicted gash massive her lower abdomen approximately six inches inside of the organization umbilicus. The depth regarding gash just stopped within abdominal fascia. The patient obtain from the emergency room that will psychiatric floor. Upon meeting the specific one day after her a chance to access E. R., she appeared presenting pajama bottoms and an undesirable t-shirt, shuffling down the hall within the socks. She was holding the ex abdomen with one hand and grown to some discomfort. Her rich hair was short and its disheveled. When the patient come to her room she sat documented on her bed. She acknowledged with blunted affect lindsay lohan cannot stop self mutilation, and described how she cut herself into a muscles in her abdomen almost dependent upon the fascia. Her voice was tremulous and action-packed. This could be considering that she had just been given her first dose of Clozaril. She stated that her mouth was dry this she needed to drink water. She then went via say that she had been getting very sleepy. The litigant felt comfortable with a job interview.
She shared personal information relating being sexually abused by her bother beginning at the age of seven until the age of fifteen. Her brother was number of years older than her and died in an injury at the age linked to eighteen. She went via say that her mother couldn't know or acknowledged the sexual abuse and that she could not tell her along with the mother idolized the young man. The client was cognizant to cognitive reframing; however she was extraordinarily critical of herself and on another hand she felt worthless and a ashamed. She appeared very tired and on another hand she wanted to sleep.
Table 1
Textbook characteristics of Bpd versus client characteristics observed
Textbook Features:
Pure Manic Episode
Hypomanic Episode
Major Depressive Episode-
Affective Flattening
Alogia
Avolition-apathy
Anhedonia
Mixed Episode
Rapid-Cycling The illness Disorder- Patients experience some or Client
Characteristics Observed:
No great symptoms
Rapid breathing, rapid oral communication, however due to medication litigant was concurrently exhibiting lethargy
Client called sadness/ worthlessness
Facial expression flat
Thoughts from the dying, hard to focus
Hair/clothes unkempt
Expressed no within children or own
Client's Symptoms
1. Hypomania
2. Depression
a. ) Efficient Flattening
b. ) Alogia
c. ) Avolition & Apathy
d. ) Anhedonia
3. Demolished Episode
4. Rapid Cycling
(Varcarolis, 2004, dom. 485)
Nursing Interventions
1. Observe the litigant every 15 minutes whilst suicidal, remove all harmful, sharp objects from room.
2. Reinforce that is actually worth while,
a. ) Assist the purchaser in evaluating the positive plus the negative aspects of her life
b. ) Encourage the actual expression of angry emotions.
c. ) Schedule regular cycles throughout the day for recreational/occupational therapy, encourage client to groom self, which have praise for completing grooming requirements.
d. ) Ensure consume'rs participation in taking feeling stabilizing medications. Watch client swallow medication.
3. Appreciate client in interpersonal remedie, cognitive-behavioral therapy,
4. Encourage client to await group therapy, and diary episodes.
Table 2
Medical Surgery, Bipolar Disorder
Drug therapy using
Mood stabilizer
Antidepressants
Antipsychotics
Education several Psychotherapy
ECT
(Varcarolis, 2002, p. 483)
Clients Healthcare Interventions
Drug therapy includes
Lithium 300mg some other h. s.
Not taking any Clozaril
Client can psychotherapy, family counseling, group therapy in the middle of hospital, and cognitive reorganizing.
None
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