BIPOLAR DISORDER AND SCHIZOPHRENIA
Martha Nyanti
Rasmussen college
10/16/2022
Appendix B
Presentation of bipolar disorder
According to Mayo Clinic (2021), the bipolar disorder presents itself in two mood swings extremities; emotional highs and emotional lows. Emotional highs are characterized by unusual talkativeness, abnormally upbeat or jumpy, poor decision-making, an exaggerated sense of self-confidence and well-being, and decreased need for sleep. Depression or emotional lows is characterized by hopelessness, emptiness, sadness, indecisiveness, thinking, planning or attempting suicide, loss of pleasure and interest in almost all activities, psychosis, and fatigue.
Disease progression if left untreated
Bipolar disorder, if left untreated, increases in severity. The symptoms of this condition may occur increasingly and at minimal intervals, which increases the risk of developing severe complications. The effect is an increased risk of hospitalization and suicide. Patients find it difficult to manage symptoms of the disorder, which reduces the chances of living every day and productive life.
The treatment regimen for bipolar disorder
Bipolar disorder is a lifelong condition; treatment options for patients are to manage symptoms. Treatment varies from patient to patient and may include antipsychotic, antidepressant, anti-anxiety, and mood stabilizer medications. Alcohol and drug abuse are associated with bipolar disorder. Therefore, substance abuse therapy is a treatment performed on addicts and drug users to help them control their addiction, which in turn helps them manage bipolar disorder. Psychological counseling is a treatment. It allows patients to focus on behaviors that decrease stress, identify and modify individual thinking patterns associated with mood shifts, and maintain a positive self-image.
Patients are also enrolled in support groups to treat bipolar disorder. These groups offer education programs to both patients and families to help them learn about the disease, its triggers, symptoms, treatment options, and management of the condition. Patients will therefore be able to learn how to cope with their situation effectively with support from their families. Patients can be admitted to a psychiatric facility. This treatment aims to reduce the number of episodes of mania and depression to ensure the patient has a chance to live a happy and productive life (Mayo Clinic, 2021).
Medication regimen
A medication regimen for bipolar disorder is prescribed based on the patient’s symptoms. Mood stabilizers are medications that are used to control the emotional highs of bipolar disorder. Antipsychotic drugs are used when a patient is under medication, but the symptoms of depression or mania persist. These medications are prescribed alone or in conjunction with other medicines. Antidepressants are medications prescribed to patients suffering from depression. These medications trigger manic episodes of bipolar disorder; hence they are specified with a mood stabilizer or antipsychotic drugs. Anti-anxiety medications are prescribed on a short-term basis to help improve sleep and manage anxiety in patients (Mayo Clinic, 2021).
Nursing role in bipolar disorder
According to Belleza (2021), nurses have a pivotal role in bipolar disorder. The part of nurses in handling patients with bipolar disorder is to provide therapeutic communication. The nurse should use short and clear sentences when managing patients with mania or emotional highs of bipolar disorder. This is because they lack concentration and may not take in lots of information at once. The nurse is responsible for providing patient safety by establishing external controls to ensure that patients feeling out of control feel safe.
The nurses’ role is to meet the physiological need of bipolar disorder patients. The nurse can decrease environmental stimulation that causes noise and distractions to ensure the patient is in a quiet environment to help them relax. In addition, nurses manage medication for patients. They measure the lithium levels of patients’ medications to ensure that dosages are in the proper proportions. Nurses promote appropriate behavior in bipolar patients by encouraging them to participate in activities such as walking and community service (Belleza, 2021).
Topics to be included in patient education
Patients should be educated on the symptoms of bipolar disorder. Here, patients are taught to recognize early signs and symptoms of mania and depression and prevent and manage the symptoms. Treatment compliance is a vital topic that should be included in patient education. Under this topic, patients are taught to comply with the prescribed treatments to ensure effectiveness. Substance abuse has been associated with bipolar disorder; therefore, it is critical to educate patients on the effects of substance abuse on their condition and ways of managing or coming out of it.
Discuss how the patient may be presented to you during this simulation
A patient with bipolar disorder may be given a severe depressive episode. The patient may show hopelessness, prolonged sadness, indecisiveness, and suicidal behavior.
Explain how you might care for this patient
The first step in caring for such a patient is conducting therapeutic communication. A bipolar patient with depression episodes may share feelings of anger, worry, and anxiety, and I can encourage the patient to express themselves more. Through therapeutic communication, I will offer encouragement to the patient and inquire how the symptoms started to get a better understanding of the patient. I will also suggest ways in which the patient can deal with overwhelming emotions that cause depression to allow the patient to control their life. Since my patient presents suicidal behavior, I will institute suicide precautions. I will institute safety plans such that the patient is under constant supervision from a close relative or friend in a safe environment.
I will also ensure that the patient is under the prescribed medication. Medications are to help the patient to improve from the current condition. I will also monitor the intake of drugs to ensure the patient does not take excess medication that will lead to overdose, which is a strategy for suicide. The nurse might care for this patient by implementing a no-suicide agreement. I will converse with the patient and encourage them to sign an agreement that prohibits them from committing suicide. The deal will help the nurse keep tabs on the patient to ensure they do not commit suicide. The nurse will also enroll the patient in a social group. These groups comprise individuals who are suffering from similar conditions. The patient will interact with people in the same situation, where they are educated on identifying signs and symptoms of their illness, treatment options, and management of the disorder.
Appendix C
Safety plan for working in an acute closed unit
Safety considerations for personal safety
Psychiatric nurses handling a patient with mental illness should always communicate by letting other staff know where and when they will interact with the patient. It is a safety precaution since the team will know where to locate their colleague in case of anything. The nurse should avoid wearing clothing or accessories like stethoscopes, necklaces, or clothing with loops that can be used to injure someone. A nurse should avoid sitting against a wall or across a door and always keep security on standby (Andrews, 2022).
Facility design
Doors are particularly ligaturing points of hanging for patients with suicidal behavior. Instead of regular doors with handles, the facility can use accordion doors with slanted tops. In addition, the transition zone between patient rooms and bathrooms should be ligature free or resistant. The height of the ceiling should be high enough to prevent patients from reaching and tampering with fixtures that could be ligature points. Electric and plumbing systems should be evaluated where they should be flush-mounted or slanted to avoid being used as ligature points. The spaces where they confine psychiatric patients should be enclosed to reduce crowding and foster social interaction. Access to the facility should be secured where the use of security pass for staff is recommended (Taylor & Zborowsky, 2019).
Important features for safety
According to Picmonic (n.d.), restraint is an essential safety feature. In case of an emergency where the patient is violent and may cause harm to oneself and others and where other therapeutic measures have not been successful, restraints come in handy. Patients with conditions like Tardive Dyskinesia experience involuntary movements comprising rapid jerking movements, which may result in bodily injury. Restraints can be used on them when other therapeutic measures have not worked. However, they should be implemented with a frequent observation of the patient, a medical order, and quick-release ties. Sometimes patients behaving in a risky and disturbing way where they are prone to damage property or cause harm to themselves or others may be secluded in a locked psychiatric intensive care unit where they are given time to calm down and reduce aggression and injuries to staff.
Appendix C
Schizophrenia
Schizophrenia is a mental illness affecting a person’s thinking, feelings, and behavior patterns. The symptoms of schizophrenia are categorized into three. Psychotic symptoms include loss of sense of reality through hallucinations and delusions. Negative symptoms comprise loss of interest in almost all activities, difficulty showing emotions, and withdrawal from social life. Cognitive symptoms include the inability to concentrate and indecisiveness. Treatments for schizophrenia aim at helping patients in the management of their symptoms and improvement in daily life. Treatments include using medications like antipsychotics, psychosocial treatments through therapy, and family and patient education and support.
Appendix D
Bipolar disorder
Bipolar disorder is a mental illness that is the leading cause of disability globally and a leading cause of premature mortality. Bipolar disorder involves severe mood disturbances, neuropsychological deficits, immunological and physiological changes, and disturbances in everyday functioning. Genetics is a common cause of the bipolar disorder, where an individual has a first-degree relative, either a sibling or parent, with this condition. Bipolar disorder is characterized by two states emotional highs and emotional lows. Patients are treated based on the symptoms they exhibit. Medications include mood stabilizers, antipsychotics, and anti-anxiety medicine.
Appendix E
Individual strengths and growth opportunities for working in mental health
Working in a mental health facility is a daunting task. However, it will help me to grow personally and as a nurse. It will allow me to be an active listener when offering therapeutic communication to patients. I will also learn to be empathetic and have compassion toward others while maintaining solid ethics in my work. I will also be in an excellent position to manage my feelings and emotions since I will be well-informed on the effects of not doing so.
References
Andrews, B. Amanda. (2022, August 10). How do psychiatric nurses/ NPs stay safe on the job?
https://www.registerednursing.org/articles/how-do-psychiatric-nurses-np-stay-safe-on-job/
Belleza Marianne. (2021, February 11). Bipolar disorder. Retrieved from
https://nurselabs.com/bipolar-disorder/
Mayo Clinic. (2021, February 16). Bipolar disorder. Retrieved from
https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955
Picmonic. (n.d.). Master use of restraints with picmonic for nurses RN. Retrieved from
https://www.picmonic.com/learn/use-of-restraints_2023
Taylor Ellen & Zborowsky Terri. (2019, February). Reducing injury and arm: Safety for behavioral & mental health. Retrieved from
https://www.healthdesign.org/insights-solutions/reducing-injury-and-harm-safety-behavioral-mental-health
