Nursing Interventions in the Analysis of Bipolar Ataxia

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 18 February 07:53   
Diagnosis Bipolar Disorder: "Bipolar ataxia is a astringent biologic affliction characterized by alternate fluctuations in mood. Typically, patients acquaintance alternating episodes in which affection is abnormally animated or abnormally depressed-separated by periods in which affection is almost normal." (Lehne, 2004, p. 321)

The afterward is a abbreviate abridgment according to the DSM-IV-TR, "Criteria for Bipolar Disorder" includes a audible aeon of aberancy and agilely elevated, expansive, or annoyed affection for at least:


    - 4 canicule for hypomania


    - anniversary for mania

During the aeon of affection disturbance, at atomic three or added of the afterward affection accept persisted and accept been present to a cogent degree:


    - Aggrandized self-esteem or grandiosity


    - Decreased charge for sleep


    - Added articulate than accepted or burden to accumulate talking


    - Boundless captivation in acceptable activities that accept a top abeyant for aching consequences." (American Psychiatric Affiliation [APA], 2000).

Psychodynamics of the Ache The access of the ache usually occurs during backward boyhood or in the mid twenties. However, the ache has been accepted to action up into the fifth decade of life. The affection swings that accompany this ataxia are of several types. They are as follows: the Authentic Berserk Episode, apparent by hyperactivity, boundless enthusiasm, and flight of ideas, connected indisposition after sleep,

Impairment in accustomed amusing activity usually acute hospitalization; Hypomanic Episode, apparent by a milder anatomy of the Authentic Mania, after the accident of accustomed activity that would crave hospitalization; Above Depressive Episode, characterized by depressed affection consisting of affection such as anhedonia, avolition, alogia, melancholia flattening and thoughts of suicide and death; the endure adventure associated with Bipolar disorders is the Alloyed Adventure in which, "patients acquaintance affection of aberration and abasement simultaneously. The aggregate of top activity and abasement puts them at cogent accident of suicide." (Lehne, 2004, p. 321)

Case Presentation


    A Caucasian woman in her mid twenties presented signs and affection of cocky anamorphosis with a beeline bend razor inflicted cleft beyond her lower belly about six inches beneath the umbilicus. The abyss of the cleft just chock-full at the belly fascia. The accommodating was beatific from the emergency allowance to the psychiatric floor. Aloft affair the accommodating one day afterwards her acceptance to E.R., she appeared dressed in pajama cheers and a t-shirt, ambiguity down the anteroom in her socks. She was captivation her belly with one duke and appeared in some discomfort. Her atramentous hair was abbreviate and disheveled. If the accommodating accustomed at her allowance she sat down on her bed. She accustomed with blunted affect that she cannot stop cocky mutilation, and declared how she cut herself through the anatomy in her belly about down to the fascia. Her articulation was aflutter and fast paced. This could be due to the actuality that she had just been accustomed her first dosage of Clozaril. She declared that her aperture was dry and that she bare to alcohol some water. She then went on to say that she was accepting actual sleepy. The applicant acquainted adequate with the interview.

She aggregate claimed advice in commendations to getting sexually abused by her bother alpha at the age of seven until the age of fifteen. Her brother was two years earlier than her and died in an auto blow at the age of eighteen. She went on to say that her mother never knew or accustomed the animal corruption and that she could not acquaint her because the mother admired the son. The applicant was acceptant to cerebral reframing; about she was actual analytical of herself and declared that she acquainted abandoned and ashamed. She appeared actual annoyed and declared that she capital to sleep.

Table 1


    Textbook characteristics of Bipolar ataxia against applicant characteristics observed

Textbook Characteristics:


    Pure Berserk Episode


    Hypomanic Episode


    Major Depressive Episode-


    Affective Flattening


    Alogia


    Avolition-apathy


    Anhedonia


    Mixed Episode


    Rapid-Cycling Bipolar Disorder- Patients acquaintance four or Client

Characteristics Observed:


    No accepted symptoms


    Rapid breathing, accelerated speech, about due to medication a applicant was accordingly announcement lethargy


    Client accustomed sadness/ worthlessness


    Facial announcement flat


    Thoughts of dying, harder to focus


    Hair/clothes unkempt


    Expressed no absorption in accouchement or own

Client`s Symptoms


    1. Hypomania


    2. Depression


    a.) Melancholia Flattening


    b.) Alogia


    c.) Avolition & Apathy


    d.) Anhedonia


    3. Alloyed Episode


    4. Accelerated Cycling


    (Varcarolis, 2004, p. 485)

Nursing Interventions

1. Beam the applicant every 15 account while suicidal, abolish all dangerous, aciculate altar from room.

2. Reinforce that she is account while,


    a.) Abetment the applicant in evaluating the absolute as able-bodied as the abrogating aspects of her life


    b.) Animate the adapted announcement of affronted feelings.


    c.) Agenda approved periods of time throughout the day for recreational/occupational therapy, animate applicant to benedict self, action acclaim for commutual grooming.


    d.) Ensure client`s accord in demography affection stabilizing medications. Watch applicant absorb medication.


    3. Appoint applicant in interpersonal therapies, cognitive-behavioral therapy,


    4. Animate applicant to appear accumulation therapy, and account episodes.

Table 2


    Medical Interventions, Bipolar Disorder


    Drug analysis using


    Mood stabilizer


    Antidepressants


    Antipsychotics


    Education and Psychotherapy


    ECT


    (Varcarolis, 2002, p. 483)

Clients Medical Interventions


    Drug analysis includes


    Lithium 300mg every h.s.


    Not demography any Clozaril


    Client is accepting psychotherapy, ancestors counseling, accumulation analysis while in hospital, and cerebral restructuring.

 


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Article In : Health & Fitness  -  Mental Health