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Mania

Powerpoint presentation on "Mania" made for the purpose of class presentation but knowledge is worthy to share

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Mania

  1. 1. 2nd August 2018 1made by Rashida GM (PGCN)
  2. 2. Presented To: Madam Zarina Katherine Presented By: Ms. Rashida GM Post-RN B.Sc (N) -2nd Prof 2nd August 2018 2made by Rashida GM (PGCN)
  3. 3. Serial No CONTENTS Page No 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Objectives Introduction Definition of Mania Classification of Mania Causes of Mania Symptoms of Mania Pathophysiological Mechanisms Onset and Clinical Course Treatment Modalities Nursing Care Plan Nursing Interventions Client Family Education Summary References 04 05 06 07 08 09 10 11 12 16 17 18 19 20 2nd August 2018 3made by Rashida GM (PGCN)
  4. 4.  At the end of this presentation participants will be able to:  Define Mania  Discuss Classification and Causes of Mania  Elaborate Symptoms and Treatment of Mania  Apply Nursing Process to the care of clients with Mania  Provide education to Clients and families for Mania 2nd August 2018 4made by Rashida GM (PGCN)
  5. 5. Mania is a term used to differentiate bipolar disorder from depression. Referring to mania as the “high” component and depression as the “low” component is common. However, mania is much more than that. 2nd August 2018 5made by Rashida GM (PGCN)
  6. 6. A mania is a distinct period during which there is an abnormally and persistently elevated, expansive, or irritable mood. This period of abnormal mood must last at least 1 week( or less if hospitalization is required). 2nd August 2018 6made by Rashida GM (PGCN)
  7. 7.  Mania can be classified into three categories which are: 1. MIXED STATUS: In a mixed state the individual has co-occurring manic and depressive features 2. HYPOMANIA: In hypomania, there is less need for sleep and both goal-motivated behavior and metabolism increase. 3. ASSOCIATED DISORDER: A single manic episode is sufficient to diagnose bipolar 1 disorder 2nd August 2018 7made by Rashida GM (PGCN)
  8. 8.  A person may experience mania as a result of a range of factors including:  Stressful events  Genetic factors  Biochemical factors ( neurotransmitter abnormalities or imbalances)  Seasonal Influences 2nd August 2018 8made by Rashida GM (PGCN)
  9. 9.  Heightened, grandiose, or agitated mood  Exaggerated self-esteem  Sleeplessness  Pressured speech  Flight of ideas  Reduced ability to filter out extraneous stimuli; easily distractible  Increased number of activities with increased energy  Multiple, grandiose, high-risk activities, using poor judgment, with severe consequences 2nd August 2018 9made by Rashida GM (PGCN)
  10. 10.  The mechanism underlying mania is unknown, but the neurocognitive profile of mania is highly consistent with dysfunction in the right prefrontal cortex, a common finding in neuroimaging studies.  Neurochemical influences of neurotransmitters (chemical messengers) focus on serotonin and norepinephrine as the two major biogenic amines implicated in mood disorders.  Deficits of serotonin found in the blood or cerebrospinal fluid occur in people with mania  Norepinephrine levels may be increased in mania. This catecholamine energizes the body to mobilize during stress and inhibits kindling .  Dysregulation of acetylcholine and dopamine also is being studied in relation to mood dysorders . 2nd August 2018 10made by Rashida GM (PGCN)
  11. 11. ONSET  The mean age for first manic episode is early 20s  Some people experience onset in adolescence, whereas others start experiencing symptoms when they are older than 50  Manic episodes typically begin suddenly, with rapid escalation of symptoms over a few days, and they last from a few weeks to several months CLINICAL COURSE  The diagnosis of mania require at least 1 week of unusual mood changes in addition to three or more manic symptoms  Clients may stop taking medications because they like the euphoria and feel burdened by the side effects , blood tests, and physicians’ visits needed to maintain treatment  They do not understand how their illness affects others 2nd August 2018 11made by Rashida GM (PGCN)
  12. 12. Two kinds of treatment modalities are used to treat mania i.e; •Psychopharmacology • Psychotherapy 2nd August 2018 12made by Rashida GM (PGCN)
  13. 13. Treatment for mania involves a lifetime regimen of medications: either of the following;  Antimanic Agent (Lithium)  Anticonvulsant Drugs Both are used as MOOD STABILIZERS ANTIMANIC AGENT (LITHIUM)  Response rate in acute mania is 70%-80%  Onset of action is 5-14 days  Periodic serum lithium levels must be monitored  Maintenance levels 0.5-1mEq/L  Treatment levels 0.8-1.5mEq/L  Toxic levels 1.5mEq/L and above 2nd August 2018 13made by Rashida GM (PGCN)
  14. 14. ANTICONVULSANT DRUGS  Carbamazepine (Tegretol)  Therapeutic level 4-12 ug/mL  Valproic Acid (Depakote)  Therapeutic level 50-125ug/mL Less frequently used are:  Gabapentin (Neurontin)  Lamoterigine (Lamictal)  Topiramate (Topamax)  Clonazepam (Klonopin) IF MOOD STABILIZERS AND ANTICONVULSANTS FAIL THEN ELECTRIC CONVULSIVE THERAPY MAY ALSO BE GIVEN TO PREVENT CLIENT FROM SUICIDAL RISKS 2nd August 2018 14made by Rashida GM (PGCN)
  15. 15. Psychotherapy combined with medication can reduce the risk for suicide and injury Provide support to the client and family Help the client to accept the diagnosis and treatment plan 2nd August 2018 15made by Rashida GM (PGCN)
  16. 16. 2nd August 2018 16 ASSESSMENT NURSING DIAGNOSIS EXPECTED OUTCOMES NURSING INTERVENTION S RATIONALE •Denial of problems •Grandiose schemes, plans, or stated self image •Buying sprees •Sexual acting out Defensive coping Repeated projection of falsely positive self-evaluation based on a self- protective pattern that defend against underlying perceived threats to positive self-regard IMMEDIATE The client will Demonstrate increased feelings of self worth STABILIZATION The client will Demonstrate appropriate appearance and behavior COMMUNITY The client will Use internal controls to modify own behavior •Ignore or withdraw your attention from bizarre appearance and behavior and sexual acting-out •Give the client positive feedback whenever appropriate • initially structure tasks at which the client will succeed. Gradually increase the number and complexity of activities •Withdrawing attention can be more effective than negative reinforcement in decreasing unacceptable behavior •It is essential to support the client in positive ways •The client may be limited in the ability to deal with complex tasks or stimuli made by Rashida GM (PGCN)
  17. 17.  Provide for client’s physical safety and those around  Set limits on client’s behavior when needed  Remind the client to respect distances between self and others  Use short, simple sentences to communicate  Clarify the meaning of client’s communication  Frequently provide finger foods that are high in calories and protein  Promote rest and sleep 2nd August 2018 17made by Rashida GM (PGCN)
  18. 18.  Teach about bipolar illness and ways to manage the disorder  Teach about medication management, including the need for periodic blood work and management of side effects  For clients taking lithium, teach about the need for adequate salt and fluid intake  Teach the client and family about signs of toxicity and the need to seek medical attention immediately  Educate the client and family about risk-taking behavior and how to avoid it  Teach about behavioral signs of relapse and how to seek treatment in early stages 2nd August 2018 18made by Rashida GM (PGCN)
  19. 19. A mania is a distinct period during which there is an abnormally and persistently elevated, expansive, or irritable mood. Its exact cause is not known but some factors are considered responsible for it. It is manifested by heightened, grandiose, or agitated mood along with sleeplessness. Treatment involves psychopharmacology and psychotherapy. 2nd August 2018 19made by Rashida GM (PGCN)
  20. 20. Sheila L. Videbeck ; Psychiatric-Mental Health Nursing; fifth edition, 2011. https://www.slideshare.net https://en.m.wikipedia.org/wiki/Mania 2nd August 2018 20made by Rashida GM (PGCN)
  21. 21. 2nd August 2018 21made by Rashida GM (PGCN)
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