Chapter 22: Bipolar Disorder in Children

Question 1

Bipolar Disorder

Answer 1

Mood Disorder

• known as manic-depression
• evidenced by mood swings (from depression to mania)

Question 2

Signs + Symptoms

Answer 2

-b/c it is a combination of major depression and mania, nurse must be aware of symptoms associated
>Mania:
-overly happy, irritable, silly, and elated; overly inflated self-esteem (grandiosity); increased energy, feels jumpy or “wired”; decreased need for sleep (able to go with very little or no sleep for days without tiring); increased talking (too much, too fast; changes topic too quickly; cannot be interrupted); distractibility (attention moves constantly from one thing to the next); hyper-sexuality (increased sexual thoughts, feelings, or behaviors, use of explicit sexual language); increased goal-directed activity or physical agitation; disregard of risk; impulsive behavior such as a spending spree
>Depression:
-persistent sad or irritable mood, worried, feeling empty; loss of interest in activities once enjoyed; change in eating and sleeping habits; physical agitation or slowing; loss of energy; feelings of worthlessness or inappropriate guilt; difficulty concentrating; recurrent thoughts of death or suicide

Question 3

Diagnosis

Answer 3

based on a thorough history and physical as well as the identification of the mood swings (from depression to mania)

Question 4

Prevention

Answer 4

• practice and teach relaxation techniques
• use firm restraint holds to control rages
• prioritize battles and let go of less important matters
• reduce stress in the home
• use good listening and communication skills
• use music and sound, lighting, water, and massage to assist the child with waking, falling asleep, and relaxation
• stress reduction at school
• prepare for stressful situations by developing coping strategies beforehand
• engage the child’s creativity through activities that express and channel gifts and strengths
• provide routines, structure, and freedom within limits

Question 5

Nursing Care

Answer 5

• understand if a child is in an acute manic state, the child is struggling against internal feelings and is not just being a “bad child”
• psychotherapy and medication indicated

Question 6

Education/Discharge

Answer 6

• remove harmful objects from the home (or lock them in a safe place) that could be used to inflict harm to self or others during a rage, especially guns
• keep medications in a locked cabinet
• watch for the child’s response/reaction to medications
• it make take 2 to 3 weeks before the medications become effective
• instruct that if symptoms escalade and become uncontrollable they need to contact their healthcare professional