BIPOLAR DISORDER

Abdul-Rahman Adnan
U19200423
Dr. Muhammad Arsyad Subu
Outline:
Health history
Scenario & Bipolar Disorder
physical assesment

Causes
Psychological etiology and
symptoms

Complications Nursing management

Medical management
& comprehensive
medication
prognosis Nursing care plan
 Yousuf Abdulla a Emirati 56 years old
man, was admitted to Al Amal Hospital on
C A S E S C E NA RI O 17 february 2023 at 11:25 pm.
Came with his brother To Male Acute
Ward for case Bipolar Disorder.
 demographic data Vital signs Diagnosis Past Medical History
Name: Y.A • Diabetes Meltus
Temp: 36.5 c • Bipolar Affective
Sex: male • Diabetic
HR: 77 bpm Disorder
Age: 56 years • Lew serum
BP: 130/89 mmHg .
Religion: Muslim vitamine D
RR: 18 bpm
Natoinality: Emirati SPO2: 100%
Date of admission: 17/02/2023
Height: 168 cm
Weight: 108 kg
BMI: 38 kg\m
Chief Complaint
Aggressive behavior, fighting
with family members, breaking
the things, anxious, not sleeping
and not eating since 5 days.
.
 BIPOLAR DISORDER

•(formerly called manic-depressive

illness or manic depression)
• is a mental illness that causes unusual
shifts in a person's mood, energy,
activity levels, concentration, and
ability to carry out day-to-day tasks.
•causes extreme mood swings that
include emotional highs (mania
or hypomania) and lows (depression).
 •The exact cause of bipolar disorder is unknown.
Experts believe there are a number of factors that work
together to make a person more likely to develop it.
These are thought to be a complex mix of physical,
environmental and social factors.
ETIOLOGY •Several factors are believed to play a role in developing
OF BIPOLAR bipolar disorder, including genetics, brain chemicals,
psychological and environmental factors, and sometimes
DISORDER medical illnesses. Bipolar disorder is frequently
inherited, with genetic factors accounting for
approximately 80% of the cause of the condition.
 The contribution of psychological factors in bipolar
disorder is increasingly recognised, both as 'risk' factors
and ongoing contributors to illness course.

PSYCHOSOCIAL OF Factors that may increase the risk of developing bipolar

BIPOLAR disorder or act as a trigger for the first episode include:
DISORDER •Having a first-degree relative, such as a parent or
sibling, with bipolar disorder.
•Periods of high stress, such as the death of a loved one
or other traumatic event.
•Drug or alcohol abuse.
 If left untreated, bipolar disorder can lead to longer and
more severe mood changes.
Someone living with bipolar disorder may also have a
higher risk of the following:
•substance abuse (for example, alcohol or drugs)
•heart and cardiovascular conditions
COMPLICATIONS
•unhealthy weight (such as obesity)
OF BIPOLAR
•Problems related to drug and alcohol use.
DISORDER
•Suicide or suicide attempts.
•Legal or financial problems.
•Damaged relationships.
•Poor work or school performance.
•suicidal thoughts
 one's prognosis depends on many factors, which are, in
fact, under the individual's control:
•the right medicines
•the right dose of each
•a very informed patient

PROGNOSIS OF •a competent, supportive and warm therapist

BIPOLAR •a supportive family or significant other
DISORDER •a balanced lifestyle including a regulated stress level,
regular exercise and regular sleep and wake times.
There are obviously other factors that lead to a good
prognosis as well, such as being very aware of small
changes in one's energy, mood, sleep and eating
behaviors, as well as having a plan in conjunction with
one's doctor for how to manage subtle changes that
might indicate the beginning of a mood swing.
 CAUSES OF BIPOLAR DISORDER

The exact cause of bipolar disorder isn’t fully understood. However, experts believe that a
combination of physical, environmental and social factors (including mental stress) can make
someone more likely to develop the condition.

Genetics Chemical imbalances Triggers

If one parent has bipolar • Bipolar disorder is a stressful circumstance

disorder, there is a 1 in
10 chance their child
will also develop the
condition. If both
parents have bipolar
disorder, the likelihood
rises to 4 in 10.
thought to occur when or experience can
your body struggles to trigger an episode of
produce and breakdown
certain brain chemicals
mania or depression.
(neurotransmitters), such This may include
as adrenaline, dopamine, childhood physical,
acetylcholine, serotonin sexual or emotional
and GABA (gamma- abuse, family conflict,
aminobutyric acid), as or other major life-
well as certain hormones. altering events.
 S Y MP TO MS O F B I P O L A R D I S O R D E R ?

DURING A feeling high, extremely happy or irritable

MANIC
PHASE: increased energy, activity and creativity, along with a reduced need to sleep

racing thoughts and speech (may be expressed as frequently talking over people) jumping
from topic to topic

being very easily distracted by any stimuli (such as noises or other people)

DURING A lack of motivation

DEPRESSIVE
PHASE : a loss of interest in usual leisure activities or hobbies

withdrawing from social contact and activities

feelings of worthlessness or guilt, which may include suicidal thoughts

MEDICAL MANAGEMENT MEDICATION
Drug name Route Dose Frequency Indication Side effects
Cough.
difficulty swallowing.
Cholecalciterol (Vitamin Oral 50,000 used to treat vitamin D deficiency.
qWeek fast heartbeat.
D3) Tablets intUnit

Feeling or being sick Stomach discomfort

Oral used for the prevention and treatment of iron deficiency
30mg Losing your appetite
Ferrous sulfate Tablets q24hr anemia in adults and children.

weakness.
Oral 2 tabs unsteadiness.
used to relieve anxiety or to produce sedation/amnesia,
LORazepam Tablets 2mg BID diarrhea.
and treatment of status epilepticus.

used to treat high blood sugar levels that are caused by a A metallic taste in the mouth
Oral
q12hr type of diabetes mellitus or sugar diabetes called type 2 Diarrhoea.
MetFORMIN Tablets 500 mg
diabetes. Stomach ache.

Constipation
Oral Used for schizophrenia, acute manic episodes, and
QUEtiapine 50mg Bedtime Swollen breasts,
Tablets adjunctive treatment for major depressive disorder.
Irregular periods

feeling tired or sleepy.

Oral 2 tabs
BID headache.
Valproic acid (500mg) Tablets 1000 mg used to treat bipolar disorder.
weight gain.
NURSING MANAGEMENT COMPREHENSIVE
NURSING CARE PLAN
 Assessment Diagnosis Planning Implementation Rational Evaluation

• Patient will • When less manic, • As mania subsides,

find one or two the client might involvement in activities
Subjective Data:- that provide a focus and
Impaired Social solitary join one or two
activities that other clients in social contact becomes
Interaction May
can relieve quiet, more appropriate.
be related to
anxiety non-stimulating Competitive games can
Disturbed
• Patient will activities. stimulate aggression and
thought
demonstrate • When possible, can increase
processes. As
an ability to provide an psychomotor activity.
Objective Data:- evidence by
“cool down” environment with • Reduction in stimuli
Intrusive and
• Patient will put minimum stimuli lessens distractability.
manipulative
feelings into • Solitary activities • Solitary activities
behaviors
words instead requiring short minimize stimuli; mild
antagonizing
of actions when attention spans physical activities
others.
experiencing with mild physical release tension
anxiety. exertion are best constructively.
initially
 Assessment Diagnosis Planning Implementation Rational Evaluation

• Patient will
display • Use short, simple and • Short attention span
Risk for self- nonviolent brief explanations or limits understanding to
Subjective Data:-
directed behavior statements. small pieces of
violence May toward others • Remain neutral as information.
be related to in the possible; Do not • Client can use
Manic hospital argue with the client; inconsistencies and value
excitement. • Patient will • Frequently assess judgments as
respond to client’s behavior for justification for arguing
Objective Data:- external signs of increased and escalating mania.
controls when agitation and • Early detection and
potential or hyperactivity. intervention of escalating
actual loss of mania will prevent the
control possibility of harm to
occurs. self or others, and
• Patient will decrease the need for
verbalize seclusions.
control of
feelings.
 Assessment Diagnosis Planning Implementation Rational Evaluation

• Patient will • Assess and • Setting limits is an

demonstrate a recognize early important step in the
Ineffective decrease in signs of intervention of bipolar
Subjective Data:-
Individual manipulative manipulative clients, especially when
Coping May behavior. behavior, and intervening in
be related to • Patient will be intervene manipulative behaviors.
Biochemical/ protected from appropriately • Early detection and
neurologic making any • Observe for intervention can prevent
changes in major life destructive harm to client or others
the brain. decisions behavior toward in the environment.
Objective Data:-
• Patient will self or others. • Judgement and reality
report an • Provide hospital testing are both
absence of legal service when impaired during acute
delusions, and if the client is mania. Client might
racing involved in need legal advice and
thoughts, and making or signing protection against
irresponsible important legal making important
actions. documents during decisions.
an acute manic
phase.
 REFERENCES

• https://www.healthdirect.gov.au/bipolar-disorder

• https://www.wikidoc.org/index.php/Bipolar_disorder_epidemiology_and_demographics

• https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

• https://www.medicalnewstoday.com/articles/complications-of-bipolar-disorder#anxiety