Bipolar Disorder: NCLEX Priorities
Bipolar I vs II, mania safety, lithium, valproate, mood stabilizers.
Bipolar features mood episodes. NCLEX tests mania safety and lithium.
Bipolar I vs II
I: at least one manic episode. II: hypomania + major depression, no full mania.
Mania
Decreased need for sleep, grandiosity, pressured speech, racing thoughts, impulsivity, risky behavior. Safety first, risk of harm to self/others.
Medications
Lithium, therapeutic 0.6-1.2 mEq/L. Valproate, lamotrigine, carbamazepine mood stabilizers. Atypical antipsychotics (olanzapine, quetiapine, aripiprazole).
Acute mania nursing
Decrease stimulation. Provide finger foods (can't sit to eat). Set firm limits. Avoid power struggles. Safety/seclusion as needed.
Frequently asked
SSRI in bipolar?
Can trigger mania. Use cautiously, usually with mood stabilizer.
Pregnancy and lithium?
1st trimester Ebstein's anomaly risk. Risk-benefit decision.
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