Nursing Management and Interventions for Bipolar Disorder

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
Fig: Nursing management of bipolar disorder

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.

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