The nurse is assigned a client diagnosed with bipolar disorder
1. Which finding would the nurse anticipate in the client's history?
1. Last year the client had an episode of extreme mania that lasted two weeks.
2. The client reports having occasional episodes of insomnia.
3. The client reports not being able to remember not being depressed, even as a child.
4. The client's family reports the client has depression but denies hypomanic symptoms.
1
Rationale 1: BPD-1 differs from BPD-2 by the degree of symptoms present. BPD-1 is the classic syndrome in which defined mania symptoms occur during the course of the disorder.
Rationale 2: BPD-1 is diagnosed when symptoms are severe. Occasional insomnia is not a severe symptom.
Rationale 3: In bipolar disorders, the client "cycles" from depression to mania. A client who cannot remember not being depressed is experiencing dysthymia, which is more common in major depressive disorder (MDD).
Rationale 4: BPD is a cycle of depression followed by manic episodes. If the family has not noticed manic episodes, it is likely these episodes are mild (which would indicate BPD-2) or absent (which would indicate depression alone).
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