Question

Which is the most appropriate nursing action for a 32 years female patient, diagnosed with bipolar affective disorder?
1. Use physical restraints
2. Establish clear boundaries
3. Use chemical restraints
4. Give ECT

Answer 1

Correct Answer - Option 2 : Establish clear boundaries

Concept:

• Bipolar disorder is a mood disorder characterized by mood swings. The patient may experience episodes of mania, hypomania, and depression.
• It can be categorized into bipolar disorder I and bipolar disorder II.

Explanation:

• A female diagnosed with the bipolar affective disorder should not be physically or chemically restrained. Physical and chemical restraints are used in case of violence or harmful behavior of the patient.
• ECT is an effective treatment for bipolar affective disorder.
• Therefore, establishing clear boundaries helps a nurse control the negative behavior of the patient.

Causes of BPAD

• Genetic causes (Monozygotic twins)
• Reduction in norepinephrine and dopamine
• Right side lesion of the limbic system
• Thalamic and basal ganglia lesions
• Steroid side effects.

Signs and Symptoms

Manic episode

• Grandiose
• High self-esteem
• Sleeplessness
• Pressured speech
• Flight of ideas
• High-risk high energy activities

Depressive episode

• Sadness
• Loss of interest
• Restlessness
• Fatigue
• Decreased concentration.

Management

• Establishing boundaries
• Psychotherapy
• ECT
• Anxiolytics
• Mood stabilizers
• Anticonvulsants
• Antipsychotics.