Essay Example on Bipolar Disorder: Assessments & Nursing Diagnosis

Q 1: Given the presenting data, what do you expect is occurring with this client? What are the assessments? Nursing diagnosis?

The presented data indicate signs of a patient who has a bipolar disorder. The condition is characterized by extreme changes in mood from high to low and from low to high. Highs are moments of madness, while lows are moments of depression (Marneros & Goodwin, 2005). The changes in mood swings are at times mixed since one might feel simultaneously elated and depressed. The conditions of the client are coherent with the described features of a bipolar patient. As indicated in the case study, the patient is a male, and since they are more exposed to bipolar than women and the behavior traits coincide with those of one suffering from a bipolar, there is no doubt that the patient has a bipolar disorder. Just as described in the case study, a bipolar patient barely sleeps with the patient, only spending four to five hours in bed; they do not enjoy eating and fail to observe hygiene. The most striking symptom of the disorder is extreme mood swings, which are characterized by tantrums when high and depression when low, and the client clearly expresses such symptoms. Additionally, the nurse prescribed a divalproex sodium to the patient, a clear indication that he had a bipolar disorder.

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The assessment of a bipolar disorder entails observation of a single lifetime episode of mania, which is characterized by euphoric or irritable mood. The standard assessments of bipolar are maniac episodes for Bipolar I, hypomanic episodes for Bipolar II, chronic, and fluctuating mild mood symptoms. The signs portrayed by the client met these assessments of bipolar. As described in the study, the patient expressed severe agitation and anger, held grandiose thoughts, and was at times depressed.

As evidenced by the nurse during the assessment, the client was identified with several signs and symptoms. The client reports having had a few sleeping hours because most of his time, he is gaming online. This was a clear indication that health disorders, such as heart disease, may face them. His thinking was so abstract that he could change the world with his gaming skills. He felt that online gaming would open a chance of becoming champion, which would cause him money. He felt like nothing was essential to him than being online; gaming was the only way to his big dreams.

The nurse diagnosed the patient with a bipolar disorder based on the medication that was given to him. Divalproex sodium (Depakote) is a drug that is primarily used in treating maniac episodes that are connected to bipolar disorder. The stable coordination compound is composed of sodium valproate and valproic acid, and it is available under various brand names such as Depakote, Depakote Sprinkles, and Depakote ER. It is a psychiatry kind of a drug that treats the client's mental disorder and influence his moods and behavior (Adhikari, 2015). The drug seemed to be suitable for his condition since it would help him control his emotions.

Q 2: The client is started on divalproex sodium (Depakote) 250mg delayed-release capsules for the client 2 * day. What are the significant side effects?

There are many effects associated with taking divalproex sodium, which is a mixture of sodium valproate and valproic acid. The effects occur to almost all the victims who take it. After the client started undergoing medication, it is beyond doubt that, the following side effects occurred to his body. First is nausea; this is an urge to vomit when you take little or much food. It also happens when one takes pills on an empty stomach (Minirth & Neal, 2005). Nausea can cause unpredicted falling and injuries.

Second, headache associated with pain slightly above the ears and eyes of the victim. The headache can be either primary or secondary. A primary headache is not related to other diseases. It includes migraine and tension headaches. On the other hand, secondary headache is related to different minor or major illnesses. Headache causes one not to concentrate well or reason improperly because it disturbs the brain cells. Headache, in most cases, is accompanied by fever, which is the high body temperature than usual.

Thirdly, divalproex sodium also causes body shaking which makes the body to be in constant movements (Marneros & Goodwin, 2005). It also causes dizziness of the body, which most affects the sight. Once the vision of the eye is tempered with, it makes images blurred hence unclear. Dizziness affects the balancing of the human body from the ears. It is a feeling which can cause a body to feel weak and imbalanced. It brings more eye strain as one struggles to see images with a clear vision.

It also causes runny noses where all the time mucous gets out uncontrollably. This gives a lot of work to whoever is under medication because one must keep high levels of hygiene. The client must have also experienced diarrhea and stomach upsets from the take of the vaccine. In addition to that, the client has faced other side effects, including loss of control of body movements, mood swings, and reduced appetite. Divalproex sodium indeed has a vast number of side effects extremely.

Q 3: Discuss in detail other pharmacologic interventions for bipolar disorders? What are the nursing interventions regarding side effects and client Education?

Besides the divalproex sodium prescribed to the client by the doctor, other drugs are associated with it. Some are used on their own, and others are used to accompany the vital medication. Doripenem, ertapenem, imipenem, meropenem, and sodium oxybate are some of the preferred drugs that can be interacted with the divalproex sodium. Doctors and pharmacists are sure of which of the backup drug would be able to monitor behavior change. It is advisable not to start, stop, or change the dosage directives given by the doctors.

Mood stabilizer drugs can be used in place of divalproex sodium and play all the roles (Marneros & Goodwin, 2005). These drugs are taken with a doctor's prescription, and all the users advised to follow the given rules to the later. Failure for the users to adhere to the measures presented, worse side effects may arise and cause difficulties. Examples of mood stabilizers are carbamazepine and lamotrigine. They work in ensuring controlled mood swings and helps one to have a predictable mood in the future. All the clients under this medication are required to consult doctors or pharmacists as a result of side effects and unusual behavior.

As the treatments undergo, if there are notable symptoms of increased depression, antipsychotic drugs are given. They ensure that one does not lose interest in activities and do not suffer deep thoughts of imaginaries. If they are given to accompany sodium Divalproex, they aid in doing away with the stress. Examples of these drugs include; aripiprazole, ziprasidone, and asenapine.

Antidepressants can trigger manic episodes, and they are prescribed along with antipsychotics or mood stabilizers to manage depression (Silk, 2017). A combination of antidepressants and antipsychotics can also work together. Anti-anxiety medications are also given on a short term basis to improve sleep. Many other drugs can be used to treat bipolar disorders.

Q 4: What are nursing Interventions for Bipolar disorders?

Nurses play different roles in taking care of patients with bipolar disorder. They offer a conducive environment that improves the self-esteem of the patients, meet their physiological needs, and guide them towards appropriate social behaviors. Nurses provide structured solitary activities to the patients to help them focus and feel secure. They also offer frequent rest periods and high-calorie fluids such as milk to the patient to prevent exhaustion and risk of severe dehydration. Nurses also maintain a low level of stimuli in the environment of the client to minimize the escalation of anxiety. They also use phenothiazines and seclusions in cases to reduce physical harm, where the patients suffer from acute mania (Marneros & Goodwin, 2005). Nurses are also mandated to observe signs of lithium toxicity such as vomiting, diarrhea, and tremor and protect clients from giving away money and possessions by holding valuables in a hospital safe until their rational judgment returns.

Nurses treat bipolar patients or prevent their states from worsening or getting into uncontrollable levels by carrying out psychotherapy to ensure that the life quality of the affected individuals improves and to avoid increased episodes. Nurses can also apply electroconvulsive therapy in treating patients with bipolar disorders. It calls for regular checkups to monitor the progress of the condition. The triggers caused by ECT cause a change in the brain chemistry that quickly reverses the symptoms of bipolar (Gamble, 2008). For patients with adverse cases of bipolar, nurses recommend that they are hospitalized.

Nurses ensure treatment and prevention of bipolar disorders by giving directives on the kind of diet which should be taken. Nurses ensure that the patients are advised on what foodstuff they need to take. Additives such as salt are dangerous and can increase toxic levels. They also provide all the possible safety rules and regulations relating to the patient's wellbeing. Close checkups ensure that clients do not struggle because they are catered for always. Besides, nurses need to provide a quiet environment and a calm approach to bipolar patients.

Nurses also encourage a lot of daily activities for the clients to avoid excess relaxation (Adhikari, 2015). They also provide the attention all the time for the bipolar disorder clients by ensuring there is therapeutic communication. The instructions offer by nurses should precise and simple since bipolar patients barely focus. Paying attention to clients is also essential to manage medication. Exercise keeps the body fit and refreshes the mind; hence does not allow room for overthinking on specific issues. Nurses advise bipolar patients always to carry out regular practices to refresh and relax their minds.

Q 5: What should be included when assessing a client for suicide?

The assessment of a client for suicide entails a detailed process that focusses on the possibility of the occurrence of suicide and mitigation strategies for patients who are likely to perform it. Psychiatrists must gather complete information about the past, recent, and present suicidal ideation and behavior of the client. The information regarding the context and history of the patient should also be gathered by psychiatrists who should also synthesize it into a prevention-oriented suicide risk formulation anchored in the life context of the patient (Gamble, 2008). Psychiatrists should also have a broad view of thinking to capture the required knowledge about the matter. It is essential to know about what is the cause of the suicidal thought if at all, it is not adolescent issues. This gives the psychologist or whoever is interviewing a basic understanding of how to support the client morally.

It is vital to access the past suicidal behavior to know whether it is a new behavior, or it has been there over time (Marneros & Goodwin, 2005). A psychiatrist should know about past suicidal thoughts and how they ended up. It is from the response that one will know the kind of moral support to give. This will assist nurses and pharmacists in determining what kind of drugs are the best fit for the client. It is wise also to ask about past risk-taking behaviors to know by what means. If there are previous attempts of suicide, it is advisable to review recent treatment history and treatment relationships. This will help the psychiatric to check whether the cause of repeat is from how...