Bipolar case study
Susan, a married 28-year-old woman, was diagnosed with an acute manic episode upon admission. Police were summoned to her apartment for a domestic incident before she was admitted. Susan started to undress in the front yard while she was playing in the street. She was out of control and would not take her medication, so her husband asked the cops to take her to the hospital. He said that Susan, who has a history of bipolar disorder, had not slept for four days and had eaten very little. Susan is a hypersexual, conceited, highly agitated person upon admission, and she disputes the need for hospitalization.
1, Right now, the HCP is issuing commands. Which types of drugs would you expect the HCP to provide on a regular basis to treat bipolar disorder? Bipolar case study.
- Lithium
- Anticonvulsants:
- Divalproex sodium (Depakote)
- Lamotrigine (Lamictal)
- Valproic acid (Depakene)
- Carbamazepine (Equetro)
- Topiramate (Topamax)
- Antipsychotics:
- Olanzapine (Zyprexa)
- Risperidone (Risperdal)
- Quetiapine (Seroquel)
- Asenapine (Saphris)
- Aripiprazole (Abilify)
- Ziprasidone (Geodon)
- Antidepressants:
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- Levomilnacipran (Fetzima)
- Duloxetine (Cymbalta, Yentreve)
- Venlafaxine (Effexor)
- Selective serotonin reuptake inhibitors (SSRIs)
- Citalopram (Celexa)
- Fluvoxamine (Luvox)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Tricyclics and tetracyclic
- Clomipramine (Anafranil)
- Amitriptyline (Elavil)
- Desipramine (Norpramin)
- Imipramine (Tofranil)
- Nortriptyline (Pamelor)
- Monoamine oxidase inhibitors (MAOIs)
- Phenelzine (Nardil)
- Tranylcypromine (Parnate)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
BUY YOUR PAPER HERE
- Why are the aforementioned drugs prescribed?
- Antidepressants can assist in controlling bipolar disorder symptoms. Neurotransmitters are molecules found in the brain that they affect.
Antipsychotics are particularly useful in the treatment of bipolar disorders that are accompanied by episodes of psychosis during periods of extreme sadness or
- Anticonvulsants assist regulate mania and bipolar disorder in addition to treating diseases that cause seizures.
- The brain uses lithium to assist regulate mood. Physicians may recommend it to treat acute manic episodes and bipolar illness.
- What more drugs would you require as PRNs in order to properly treat Susan’s symptoms?
Answer. Anxiety-reducing drugs: Benzodiazepines are typically used temporarily, though they may reduce anxiety and enhance sleep. Bipolar case study.
- List three mood stabilizers that are used to treat bipolar disorder.
- Lamotrigine (Lamictal),
- Valproic acid (Depakene),
- Lithium (Lithobid).
- Given Susan’s age and marital status, the following should be taken into consideration before beginning a mood stabilizer:
- Valproate may raise testosterone levels in female patients. Periods ceasing and abnormal hair growth may result from this.
- Consuming lithium may cause your blood salt levels to rise, which may result in lithium toxicity. Diarrhea or vomiting, consuming insufficient amounts of water, or using other medications may exacerbate this.
- Mood stabilizers may make you more susceptible to sunburn: When you’re outside, use sunscreen to avoid
- Take your medication with food to minimize upset stomach or
- Mood stabilizer medication may result in weight gain. Weight gain can be avoided by engaging in regular exercise and eating a low-fat, low-sugar, high-fiber diet that includes fruits, vegetables, and bran.
- The HCP directs the PO bid of 300 mg of lithium and the drawing of a lithium level four days before the morning dose. Describe the rationale behind the lithium level monitoring.
Answer. Lithium levels in the blood are measured to establish the therapeutic level when beginning lithium treatment, to track levels to make sure they stay within the therapeutic range, and occasionally to assess lithium toxicity. Weight gain can be avoided with regular exercise and a low-fat, low-sugar, high-fiber diet that includes fruits, vegetables, and bran.
7, Susan complained of mild nausea, increased thirst, and frequent urination two days after starting the lithium. She also had these symptoms before taking her morning dose of lithium. Susan is also suffering weariness and tiny tremors, according to additional evaluation. In what way would you address Susan’s complaints? Why?
- Pumping of the stomach. In the event that you have taken lithium inside the previous
- Whole bowel irrigation: this method can assist in removing excess lithium from your intestines.
IV fluids: they replenish your electrolyte levels; hemodialysis: these eliminate waste from your body; medication: these include anticonvulsant drugs. When experiencing seizures
- Vital sign monitoring: Keep an eye on your heart rate and blood pressure, among other vital signs, for any odd.
- List the two nursing interventions that will be used to treat Susan’s symptoms.
- Keep environmental stimulation to a minimum (such as bright lights, loud noises, and low temperatures)
- Keep an eye out for symptoms of lithium toxicity, such as dizziness, nausea, vomiting, diarrhea, trembling, weakness in your muscles, trembling, lack of coordination, impaired vision, or ringing in your ears.
- After four days The next dose is due to be given to Susan on schedule; her lithium level is 0.4. Right now, what step would you take? Bipolar case study.
Answer. There is a relatively small window of time in which lithium is safe and effective. A lithium concentration of 1.2 mEq/L can be problematic. levels ought to range between 0.6 to 1.2 mEq/L, but not above that amount. If the medication’s levels are too low, it might not improve your condition. Lithium levels in the blood can be impacted by both salt and liquids, therefore it’s critical to eat the same quantity each day. Consuming more salt can lower your lithium levels while consuming less salt can raise them. For this patent, reducing and restricting
- After her medication was reduced, Susan’s lithium level dropped to 0.8 two weeks later, and she was allowed to return home. Which pharmaceutical instruction on safe lithium administration would need to be included in her discharge instructions?
PLACE YOUR ORDER HERE
- Keep an eye out for prolonged thirst and increased production of diluted urine. Lowering the dosage could be
- If you get fever or diarrhea, call your doctor. Steer clear of activities that could cause dehydration, such as hot environments and high-caffeine drinks (diuresis).
- During the stabilization phase, consume 2-3 L/d of liquids, and during the continuing
- Steer clear of self-managed low-sodium regimens, self-dosing with sodium-containing antacids, and meals high in sodium (such as prepared meats and diet Coke).
- Wait to drive or conduct any other potentially dangerous activity until you know how the medicine will affect you. Lithium may cause mental and physical problems.
- Use reliable birth control methods while on lithium Serum lithium levels need to be regularly checked if therapy is prolonged during pregnancy in order to avoid toxicity. Bipolar case study.
- Do not breast feed while taking this.