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Mania, Pathophysiology - Coggle Diagram
Mania
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Nursing intervention
Providing for safety. A primary nursing responsibility is to provide a safe environment for client and others; for clients who feel out of control, the nurse must establish external controls emphatically and nonjudgementally.
Meeting physiologic needs. Decreasing environmental stimulation may assist client to relax; the nurse must provide a quiet environment without noise, television, and other distractions; finger foods or things client can eat while moving around are the best options to improve nutrition.
Providing therapeutic communication. Clients with mania have short attention spans, so the nurse uses simple, clear sentences when communicating; they may not be able to handle a lot of information at once, so the nurse breaks information into many small segments.
Promoting appropriate behavior. The nurse can direct their need for movement into socially acceptable, large motor activities such as arranging chairs for a community meeting or walking.
Managing medications. Periodic serum lithium levels are used to monitor the client’s safety and to ensure that the dose given has increased the serum lithium level to a treatment level or reduced it to a maintenance level.
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Medication
Anxiolytics, benzodiazepines. By binding to specific receptor sites, benzodiazepines appear to potentiate the effects of gamma-aminobutyric acid (GABA) and facilitate inhibitory GABA neurotransmission and the action of other inhibitory neurotransmitters.
Mood stabilizers. Lithium is the drug commonly used for prophylaxis and treatment of manic episodes.
Anticonvulsants. Anticonvulsants have been effective in preventing mood swings associated with bipolar disorder, especially in those patients known as rapid cyclers.
Antipsychotics, 2nd generation. Second generation, or atypical, antipsychotics are increasingly being used for treatment of both acute mania and mood stabilization in patients with bipolar I disease.
Antipsychotics, 1st generation. First-generation antipsychotics, also known as conventional or typical antipsychotics, are efficacious in treating both psychotic and nonpsychotic manic and mixed episodes, as well as hypomania.
Antipsychotics, phenothiazine. Phenothiazine antipsychotics, which are classified as first-generation antipsychotics, are efficacious in treating both psychotic and nonpsychotic manic and mixed episodes, as well as hypomania.
Antiparkinsons agents, dopamine agonists. Dopamine agonists are non-errgot agents that bind to D2 and D3 dopamine receptors in the striatum and substantia nigra.
ongoing assessment
History. Taking a history with a client in a manic phase often proves difficult; obtaining data in several short sessions, as well as talking to family members, may be necessary.
General appearance and motor behavior. Client with mania experience psychomotor agitation and seem to be in perpetual motion; sitting still is difficult; this continual movement has many ramifications; clients can be exhausted or injure themselves.
Mood and affect. Mania is reflected in periods of euphoria, exuberant activity, grandiosity, and false sense of well being.
Thought process and content. Cognitive ability or thinking is confused and jumbled with thoughts racing one after another, which is often referred to as flight of ideas; clients cannot connect concepts, and they jump from one subject to another.
Pathophysiology
The genetics component of bipolar disorder appears to be complex; the condition is likely to be caused by multiple different common disease alleles, each of which contributes a relatively low degree risk on its own.
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These loci are grouped as major affective disorder (MAFD) loci and numbered in the order of their discovery.