Diagnosis Bpd: "Bipolar disorder is an extreme biologic illness characterized that includes recurrent fluctuations in place. Typically, patients experience alternating episodes understand that mood is abnormally horse racing or abnormally depressed-separated by periods that we mood is relatively traditional. " (Lehne, 2004, dom. 321)
The following is a short synopsis mainly because DSM-IV-TR, "Criteria for Bipolar Disorder" has a distinct period of abnormality and persistently elevated, fast, or irritable mood having a minimum of:
- 4 days for hypomania
- week for mania
During any mood disturbance, at least three or bags is a following symptoms have persisted and also have present to a a significant degree:
- Inflated self-esteem or grandiosity
- Decreased importance of sleep
- More talkative than usual or pressure to keep talking
- Excessive availability of pleasurable activities by getting a high potential for aggravating consequences. " (American Psychiatric Association [APA], 2000).
Psychodynamics within your Disease The onset with the disease usually occurs during late adolescence maybe in the mid twenties. Though the, the disease has endured to occur up inside your fifth decade of stage. The mood swings that accompanies this disorder are of countless types. They are the following: the Pure Manic Play, evidenced by hyperactivity, a high enthusiasm, and flight considering all of ideas, constant wakefulness with not sleep,
Impairment in not uncommon social functioning usually purchasing hospitalization; Hypomanic Episode, evidenced through a milder form of with regard to Pure Mania, without stopping normal functioning that require hospitalization; Major Depressive Incident, characterized by depressed mood made up of symptoms such as anhedonia, avolition, alogia, affective flattening and thoughts of suicide and death; the the final associated with Bipolar disorders will likely be Mixed Episode in who are, "patients experience symptoms obviously mania and depression all together. The combination of symbolizes the best and depression puts them at significant likelihood suicide. " (Lehne, 2004, dom. 321)
Case Presentation
A Caucasian woman in his mid twenties presented indications of self mutilation with a straight edge razor inflicted gash by the her lower abdomen approximately six inches plantar to umbilicus. The depth within your gash just stopped inside abdominal fascia. The patient obtained from the emergency room regarding the psychiatric floor. Upon meeting an employee one day after her accessibility E. R., she appeared creating pajama bottoms and an everyday t-shirt, shuffling down the hall in his socks. She was holding her abdomen with one hand and appeared in some discomfort. Her darkish hair was short as well as disheveled. When the patient reached her room she sat on her bed. She acknowledged with blunted affect your daughter cannot stop self mutilation, and described how she cut herself coming from muscles in her abdomen almost with the fascia. Her voice was tremulous and hard. This could be because the that she had just been given her first spot of Clozaril. She stated that a mouth was dry feeling that she needed to drink water. She then went to be able to say that she had previously been getting very sleepy. Customer felt comfortable with the interview.
She shared personal information in regards to being sexually abused with some her bother beginning at the age of seven until the age of fifteen. Her brother was eighteen months older than her and died in something unforeseen at the age it's eighteen. She went to be able to say that her mother never knew or acknowledged the sexual abuse plus which she could not tell her as being the mother idolized the earliest. The client was aware of cognitive reframing; however she was poorly critical of herself and declared that she felt worthless and make ashamed. She appeared very tired and declared that she wanted to go to sleep.
Table 1
Textbook characteristics of Bpd versus client characteristics observed
Textbook Details:
Pure Manic Episode
Hypomanic Episode
Major Depressive Episode-
Affective Flattening
Alogia
Avolition-apathy
Anhedonia
Mixed Episode
Rapid-Cycling The illness Disorder- Patients experience nearly four or Client
Characteristics Observed:
No modern symptoms
Rapid breathing, rapid spoke, however due to medication a customer was concurrently exhibiting lethargy
Client thought of sadness/ worthlessness
Facial expression flat
Thoughts involving dying, hard to focus
Hair/clothes unkempt
Expressed no enthusiasm children or own
Client's Symptoms
1. Hypomania
2. Depression
a. ) Efficient Flattening
b. ) Alogia
c. ) Avolition & Apathy
d. ) Anhedonia
3. Together Episode
4. Rapid Cycling
(Varcarolis, 2004, dom. 485)
Nursing Interventions
1. Observe the customer every 15 minutes even if suicidal, remove all damaging, sharp objects from flat.
2. Reinforce that she is worth while,
a. ) Assist the order in evaluating the positive as well as the negative aspects of a girl life
b. ) Encourage the relevant expression of angry intuition.
c. ) Schedule regular cycles throughout the day to their recreational/occupational therapy, encourage purchaser to groom self, produce praise for completing grooming requirements.
d. ) Ensure custome'rs participation in taking aura stabilizing medications. Watch purchaser swallow medication.
3. Make use of client in interpersonal techniques, cognitive-behavioral therapy,
4. Encourage client to use group therapy, and newspaper episodes.
Table 2
Medical Surgery, Bipolar Disorder
Drug therapy using
Mood stabilizer
Antidepressants
Antipsychotics
Education and check out Psychotherapy
ECT
(Varcarolis, 2002, p. 483)
Clients Medical Interventions
Drug therapy includes
Lithium 300mg any single h. s.
Not taking any Clozaril
Client could get psychotherapy, family counseling, group therapy although hospital, and cognitive upgrading.
None
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