Clinical Assignment - Bipolar Scenario

Answer :

Identify S/S of mania

There are 2 types of mania; there is Mania and hypomania. They are different but they also have the same symptoms. The difference between the two is, that mania is more severe than hypomania. Symptoms of these two are Abnormally upbeat, jumpy or wired, Increased activity, energy or agitation, Exaggerated sense of well-being and self-confidence (euphoria), Decreased need for sleep, Unusual talkativeness, Racing thoughts, and Distractibility and Poor decision-making, for example, going on buying sprees, taking sexual risks or making foolish investments. Identify side effects of Lithium

Side effects of lithium that less common are confusion, poor memory, or lack of awareness, fainting; fast, pounding, or irregular heartbeat or pulse; frequent urination increased thirst slow heartbeat stiffness of the arms or legs troubled breathing, unusual tiredness or weakness weight gain. Lithium's rare side effects are Blue color and pain in the fingers and toes, coldness of the arms and legs, dizziness eye pain, headache, and noise in the ears vision problems.

S/S of toxicity

Signs and symptoms of lithium toxicity are diarrhea, vomiting, drowsiness, muscle weakness, tremors, unsteadiness, or other problems with muscle control or coordination.

Identify normal levels of lithium

Normal levels of lithium 0.8-1.2 mEq/L

Pre-briefing: Patient being admitted to mental health unit with a diagnosis of schizophrenia.R. B., who has just been admitted. This was his first admission, and he has been diagnosedwith schizophrenia, paranoid type. He is 22 years old and has been attending the localuniversity and living at home with his parents. He has always been a good student and hasbeen active socially. Last semester his grades began to decline, and he became verywithdrawn. He spends most of his time alone in his room. His grooming has deteriorated; hemay go days without bathing. For several weeks before admission, he insisted on keeping all ofthe blinds and curtains in the house closed. He spoke to his parents about the neighbors spyingon him. For the last 2 days he has refused to eat, saying, “They have contaminated the food”;and he only eats food after he has performed a “cleansing ritual” over them. As you approach R.B., you note that he appears to be carrying on a conversation with someone, but there is no onethere. When you talk to him, he looks around and answers in a whisper but gives you littleinformation.

Identify nursing interventions for a patient with schizophrenia:
- Establish trust and rapport; after the trust is made with the patient, the health care teamand proceed to try to make him participate in the tasks such as answering some of thequestions asked.
- Ensure safety by trying to find a way that the patient feels safe when you are giving hisfood.
- Use distractions such as group activities.
- Deal with hallucinations by presenting reality
Communicate therapeutically with a patient with schizophrenia:
- examine what hallucinations are about. Do not argue about your hallucinations. Tell themyou don't see, hear, smell, or feel anything, but that you know his hallucinations aregenuine.
- Assist him in learning social skills by providing assistance.
- Administer recommended medications and urge the patient to follow instructions.
Provide patient and family teaching for antipsychotic medications:
- These medicines are used mainly to help treat mania and psychosis.
- They can help people with schizophrenia minimize or regulate delusions andhallucinations (psychosis). They're also utilized to alleviate tension and anxiety. They canhelp with memory and thinking issues (cognitive impairment).
- Ensure that the patient takes the medications on time
- Report any of the side effects of the drugs.
- Also educate individuals of the family to perceive approaching backslide (for exampleapprehension, sleep deprivation, diminished capacity to focus)