Friday, May 9, 2008

AFFECTIVE DISORDERS [MANIA, Nursing the Overactive Patient]


MANIA

Is more common in those individuals with a CYCLOTHYMIC PERSONALITY [Where the Mood of the person Often Swings quickly from Happiness to Sadness].

It is characterized by an ELATED, EUPHORIC Mood and PSYCHOMOTOR OVER ACTMTY. Their Thoughts can be compared to a tape recorder on "fast forward". The ideas go through his mind too quickly for him to concentrate on one idea (FLIGHT of IDEAS). When he tries to tell you about his ideas he has to do it very quickly, or he will have moved on to another thought (pressure of SPEECH).

He may have GRANDIOSE DELUSIONS where he believes that he is a very important and rich person. his mood is usually very happy and most nurses and patients enjoy being with a patient in an overactive manic state. However, they easily become bored and FRUSTRATED, and interfere with other people. If they are not diverted into harmless activities they can either become AGGRESSIVE or make others aggressive.

PHYSICAL TREATMENT
Drugs used in the treatment of Mania are: 
a. LITHIUM: (Reverse symptoms in 70-80% of cases)
b. NEUROLEPTICS
c. Haloperidol [Haldol, Serenace]
d. Phenothiazines [Chlorpromazine, Triflouperazine]
e. CARBAMAZEPINE [An Anti-Conversant that seems to be effective]
f. ELECTRO CONVULSIVE THERAPY:¬ May be used where Chemotherapy has no effect. or where the patient's life is in danger from exhaustion.

NURSING CARE

These patients have far too much energy to Eat, Drink or Sleep. There is a very real danger that they will die from DEHYDRATION and EXHAUSTION.

They need to be nursed in a NON¬STIMULATING environment. Food and Drink needs to be given in small amounts and frequently. Trying to get them to sit down to eat or drink may provoke aggression.

Trying to restrain and quietness these patients will Not be successful and will only frustrate the nurse and the patient. It is more sensible to have a number of small tasks of physical activities to do WITH the patient to divert him.

The overactive patient may lose any sense of
DANGER or what is RIGHT or WRONG. They may become UNINHIBITED and take off their clothes and make sexual approaches to other patients. Therefore to protect them LIMITS may be set to their behavior. In this Limit Setting and the Administration of Medicines Physical Restraint may have to be used as a Therapeutic Technique.


KEY POINTS
I) Is more common in those with a CYCLOTHYMIC PERSONALITY
2) It is characterized by an ELA TED, EUPHORIC Mood and PSYCHOMOTOR OVER ACTIVITY.
3) Ideas go through his mind so quick(v that he has FLIGHT of IDEAS and PRESSURE OF SPEECH.
4) He may have GRANDIOSE DELUSIONS, become bored and FRUSTRATED, and then, either become AGGRESSIVE, or make others aggressive.
5) LITHIUM, NEUROLEPTICS, CARBAMAZEPINE and ELECTRO CONVULSIVE THERAPY are physical therapies used in the treatment of Mania.
6) There is a very real danger that they will die from DEHYDRA TION and EXHAUSTION.

7) They need to be nursed in a NON¬STIMULA TING environment. Food and Drink needs to be given in small amounts and frequently.
8) Have a number of small tasks or physical activities to do WITH the patient to divert him.
9) They may become UNINHIBITED "and take off their clothes and make sexual approaches to other patients. Therefore to protect them LIMITS may be set to their behavior.

1 comment:

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