Nursing Interventions and Management of Bipolar Disorder
What is Bipolar Disorder?
Bipolar disorder is a brain disorder that cause unusual shifts in a person’s mood energy and ability to function. It is a long term illness which has to be carefully managed throughout a person’s life’.
Nursing Management of Bipolar Disorder:
Nursing management of a patient with bipolar disorder includes the following:
A. Nursing Assessment:
Assessment of a patient with bipolar disorder includes:
1. History:
Taking a history with a client in a manic phase often proves difficult; obtaining data in several short sessions, as well as talking to family members, may be necessary.
You can read: Sign, Symptoms and Management of Bipolar Disorder
2. General appearance and motor behavior:
Client with mania experience psychomotor agitation and seem to be in perpetual motion; sitting still is difficult; this continual movement has many ramifications; clients can be exhausted or injure themselves.
3. Mood and affect:
Mania is reflected in periods of euphoria, exuberant activity, grandiosity, and false sense of wellbeing.
4. Thought process and content:
Cognitive ability or thinking is confused and jumbled with thoughts racing one after another, which are often referred to as flight of ideas; clients cannot connect concepts, and they jump from one subject to another.
B. Nursing Diagnosis for Bipolar Disorder:
Nursing diagnoses commonly established for clients in the manic phase are as follows:
- Risk for other-directed violence related to manic excitement, suspicion of others, paranoid ideation.
- Risk for injury related to extreme hyperactivity, destructive behaviors.
- Imbalanced nutrition: less than body requirements related to refusal or inability to sit still long enough to eat meals.
- Disturbed thought processes related to psychotic process.
- Disturbed sensory perception related to sleep deprivation, psychotic process.
C. Nursing Care Plan and Goals for Bipolar Disorder:
Nursing care planning goals for bipolar disorders are:
- Client will no longer exhibit potentially injurious movements after 24 hours with administration with administration of tranquilizing medications.
- Client will experience no physical injury.
- Client’s agitation will be maintained at manageable level with the administration of tranquilizing medications during first week of treatment.
- Client will not harm self or others.
- Client will consume sufficient finger foods and between-meal snacks to meet recommended daily allowances of nutrients.
- Within one week, client will be able to recognize and verbalize when thinking is non- reality based.
- Client will be able to recognize and verbalize when he or she is interpreting the environment inaccurately.
D. Nursing Interventions for Bipolar Disorder:
Nursing interventions for bipolar disorder client are:
1. Providing for safety:
A primary nursing responsibility is to provide a safe environment for client and others; for clients who feel out of control, the nurse must establish external controls emphatically and nonjudgmental.
2. Meeting physiologic needs:
Decreasing environmental stimulation may assist client to relax; the nurse must provide a quiet environment without noise, television, and other distractions; finger foods or things client can eat while moving around are the best options to improve nutrition.
3. Providing therapeutic communication:
Clients with mania have short attention spans, so the nurse uses simple, clear sentences when communicating; they may not be able to handle a lot of information at once, so the nurse breaks information into many small segments.
4. Promoting appropriate behavior:
The nurse can direct their need for movement into socially acceptable, large motor activities such as arranging chairs for a community meeting or walking.
5. Managing medications:
Periodic serum lithium levels are used to monitor the client’s safety and to ensure that the dose given has increased the serum lithium level to a treatment level or reduced it to a maintenance level.
E. Evaluation:
The goals are met as evidenced by:
- Client is able to differentiate between reality and unrealistic events or situations:
- Client is able to recognize thoughts that are not based in reality and intervene to stop their progression.
- Client has gained or maintained weight during hospitalization.
- There is no evidence of violent behavior to self and others.
- Client is no longer exhibiting signs of physical agitation.
F. Documentation Guidelines:
Documentation in a patient with bipolar disorder includes:
- Individual findings, including factors affecting, interactions, nature of social exchanges, specifics of individual behavior.
- Cultural and religious beliefs and expectations.
- Plan of care.
- Teaching plan.
- Responses to interventions, teaching, and actions performed.
- Attainment or progress toward the desired outcome.
