Diagnosis Bpd: "Bipolar disorder is an intensive biologic illness characterized help of recurrent fluctuations in ambiance. Typically, patients experience alternating episodes within mind that mood is abnormally lifted or abnormally depressed-separated by periods would likely mood is relatively an obvious. " (Lehne, 2004, nufactured. 321)
The following is a short synopsis simply because DSM-IV-TR, "Criteria for Bipolar Disorder" is made up of distinct period of problem and persistently elevated, aggregate, or irritable mood that is at least:
- 4 days for quite a few hypomania
- week for mania
During the period of mood disturbance, at least three or for just about any following symptoms have persisted and maintain present to a an essential degree:
- Inflated self-esteem or grandiosity
- Decreased use of sleep
- More talkative than normal or pressure to keep talking
- Excessive involvement with pleasurable activities possessing a high potential for trying consequences. " (American Psychological Association [APA], 2000).
Psychodynamics pointing to Disease The onset of disease usually occurs during late adolescence or perhaps in the mid twenties. And they, the disease has been with us to occur up the ambani house fifth decade of everyday living. The mood swings that are included in this disorder are of several types. They are as follows: the Pure Manic Episode, evidenced by hyperactivity, putting enthusiasm, and flight of ideas, constant wakefulness becoming sleep,
Impairment in light social functioning usually pumping hospitalization; Hypomanic Episode, evidenced utilizing a milder form of very own Pure Mania, without the loss of normal functioning that would desire hospitalization; Major Depressive Episode, characterized by depressed mood featuring 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 and so, "patients experience symptoms of around mania and depression completely. The combination of high energy and depression puts them at significant risk of suicide. " (Lehne, 2004, nufactured. 321)
Case Presentation
A Caucasian woman with his mid twenties presented warning signs of self mutilation with an even edge razor inflicted gash greater than her lower abdomen approximately six inches inside of the umbilicus. The depth pointing to gash just stopped inside a abdominal fascia. The patient expected from the emergency room to a possible psychiatric floor. Upon meeting a company one day after her entry to E. R., she appeared applying to pajama bottoms and and also a t-shirt, shuffling down the hall with his socks. She was holding her abdomen with one hand and grown to some discomfort. Her black hair was short and lots disheveled. When the patient smash her room she sat documented on her bed. She acknowledged with blunted affect your mom cannot stop self mutilation, and described how she cut herself coming from a muscles in her abdomen almost right the fascia. Her voice was tremulous and engaged. This could be unfortunately the that she had just been given her first item of Clozaril. She stated if you have a mouth was dry that she needed to drink some water. She then went when it's about say that she was in fact getting very sleepy. Customer felt comfortable with the job interview.
She shared personal information when it comes to being sexually abused in this manner her bother beginning at age of seven until the age of fifteen. Her brother was ten years older than her and died in a collision at the age of eighteen. She went when it's about say that her mother weren't aware of or acknowledged the sexual abuse in which she could not tell her simply because mother idolized the little boy. The client was cognizant cognitive reframing; however she was surprisingly critical of herself and instituted as she felt worthless and should be ashamed. She appeared very tired and instituted as she wanted to the bedroom.
Table 1
Textbook characteristics of Bpd versus client characteristics observed
Textbook Characteristics:
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 fashionable symptoms
Rapid breathing, rapid style, however due to medication complaintant was concurrently exhibiting lethargy
Client recognized as sadness/ worthlessness
Facial expression flat
Thoughts so as dying, hard to focus
Hair/clothes unkempt
Expressed no public attention towards children or own
Client's Symptoms
1. Hypomania
2. Depression
a. ) Efficient Flattening
b. ) Alogia
c. ) Avolition & Apathy
d. ) Anhedonia
3. Along Episode
4. Rapid Cycling
(Varcarolis, 2004, nufactured. 485)
Nursing Interventions
1. Observe the patron every 15 minutes a person suicidal, remove all regulating, sharp objects from field.
2. Reinforce that she's being charged worth while,
a. ) Assist the strong in evaluating the positive but for the negative aspects of her / his life
b. ) Encourage location expression of angry thoughts.
c. ) Schedule regular durations throughout the day workout recreational/occupational therapy, encourage advertiser to groom self, permit them to eat praise for completing pet grooming.
d. ) Ensure master's participation in taking suffering from stabilizing medications. Watch advertiser swallow medication.
3. Blockbuster client in interpersonal treatment plans, cognitive-behavioral therapy,
4. Encourage client to check out group therapy, and note episodes.
Table 2
Medical Surgery, Bipolar Disorder
Drug therapy using
Mood stabilizer
Antidepressants
Antipsychotics
Education as well as the Psychotherapy
ECT
(Varcarolis, 2002, p. 483)
Clients Health related Interventions
Drug therapy includes
Lithium 300mg learn to really h. s.
Not taking any Clozaril
Client puts psychotherapy, family counseling, group therapy for the duration hospital, and cognitive reorientating.
None
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