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5/13/2020Nursing Procedurelnareference.wkhpe.com/ref/view.do?key=49328aa9e23895f9d25d1713a8017fe4667ff869&nmn=openProcedure&procedureId=4841/5Print PageNursing Procedures and Skills: Manic episode patient careIntroductionBipolar disorder is an illness that leads to extreme and erratic shifts in an individual's mood, thinking,and behavior. It's subcategorized into bipolar I and bipolar II disorder. For a diagnosis of bipolar Idisorder, a patient must meet the criteria for a manic episode. The manic episode may have beenpreceded by and may be followed by hypomanic or major depressive episodes. For a diagnosis ofbipolar II disorder, a patient must meet the criteria for a current or past hypomanic state and thecriteria for a current or past major depressive disorder.1Mania is one of the primary symptoms of bipolar I disorder. A patient with mania is likely to experiencefeelings of extreme happiness and elation, increased energy, and decreased need for sleep and food.The speech and thoughts of a manic patient are described commonly as "racing." A manic patienttypically has a short attention span and can be easily distracted, which can cause the patient tobecome impulsive, intrusive, irritable, argumentative, and potentially violent.During a manic episode, a patient's judgment may be impaired and the patient may engage inbehavior that increases the risk of harm. The patient may also experience psychosis (a break withreality), inflated self-esteem, grandiose or delusional ideas, hallucinations, increased sexual drive, andsevere anxiety.Individuals experiencing mania may present at various settings, including primary care settings,schools, and hospitals. It's important to be aware of measures that can help manage a manic patient'ssymptoms and the adverse effects of medications prescribed to maintain emotional stability. Thepatient should be assessed and monitored for risk of injury, risk of violent behavior directed at self orothers, nutritional deficiencies, and impaired social interactions. The patient's wishes, needs, andpreferences should be honored, when possible, provided they don't interfere with the care planestablished for the manic episode.EquipmentIntake and output monitoring equipmentScalePrescribed medicationsSuicide assessment toolImplementationDon't leave the patient unattended before you have the opportunity to perform your initialassessment 2Review the patient's medical record for a history of psychiatric illness, medication use, and othermedical disorders.Perform hand hygiene.345678Confirm the patient's identity using at least two patient identifiers.9Introduce yourself to the patient
5/13/2020Nursing Procedurelnareference.wkhpe.com/ref/view.do?key=49328aa9e23895f9d25d1713a8017fe4667ff869&nmn=openProcedure&procedureId=4842/5Assess the stage of the patient's mania by observing mood, cognition and perception levels, andactivity and behavior Assess the patient's risk factors for suicide using a suicide assessment tool appropriate for thepatient's age and characteristics.