Head to toe assessment of a patient with Bipolar 1 disorder

The ‘head to toe assessment’ of the nursing care delivery system of a patient with Bipolar I disorder includes physical and psychological components. Bipolar I disorder is characterised by manic or mixed episodes at any point in the lifetime, or by major depressive episodes. Here's a structured approach to the assessment

 1. General Appearance and Behavior

 Observation: See at the state of health and cleanliness of the patient, reason for contracting the sickness and other related aspects.

 Manic Episode: Handwriting may be often clumsy, the person may look nervous, fat or thin, may have an untidy appearance and improper dressing sense. This is so due to features such as rushing, hyperactivity and distractibility.

 Depressive Episode: Children can look droopy, unwashed, untidy, and possibly even dirty and or stinking. This is because members of the community might interpret depression in a way they understand it, they may discover it as a general tiredness, slowness in physical activity and lack of facial expression or even a frown.

 2. Vital Signs

 Blood Pressure: For any use of mood stabilisers or antidepressants to be on the look out.

 Heart Rate: Honeberman and coworkers Looking for other things that might be impacted by mood-stabilising medications.

 Respiratory Rate: Check on any issues that may crop up out of the side effects of these medications.

 Temperature: Check for signs of infection or inflammation where the tattoo is going to be done.

 3. Head and Neck

 Head: Be on the lookout for any traces of self-care, or physical abuse.

 Eyes: It is important to look for any sign of dilation or constriction that could be as a result of taking some medication or the use of some drugs.

 Ears: Hear patient/ース and safely ask about the existence of complaint on side effects of medications.

 Nose: Look for sign of use of substance.

 Mouth: Search for any appearance of dry mouth, or any other side effects of the medications that have been administered, and look at out for any complication in regard to the teeth.

 4. Cardiovascular System

 Heart Sounds: If palpitations are as a result of medications, be observant of them.

 Peripheral Pulses: Much effort should also be made in getting any manifestation of peripheral vascular complications.

 5. Respiratory System

 Breath Sounds: Pay attention to the absence or presence of normal breathing sounds and look out for suffocation which may be occasioned by certain medication.

 6. Gastrointestinal System

 Abdomen: Assessment for/general assessment/tenderness or swelling: conduct by G. Deep palpation: The type of information that can be obtain from this assessment includes enlargement of organs or any other irregularity. When assessing patient’s abdomen, do not forget to look for changes in bowel sounds and check for constipation or diarrhoea which may be effect of drugs given to the patient.

 7. Musculoskeletal System

 Movement: Whether an individual is a jovial constitution or a sedentary one, their activity level may progressively wear out, assess the patient’s motility and search for signs of restlessness.

 Muscle Tone: Look out for any signs of excessive rigidity of muscles or jerking particularly if the patient has been administered with some drugs.

 8. Neurological System

 Level of Consciousness: Evaluate the patient’s overall mental status, and especially the degree of patient’s awareness of their environment, self and surroundings, time.

 Manic Episode: Most likely to be talkative, more often than not obnoxious and have bad judgment.

 Depressive Episode: May appear to be bewildered or to have difficulty in concentration.

 Cognition: Cognitive tests include; memory, judgment and problems solving checks including the mini mental status examination.

 Motor Activity: It is very important and should be a directive to pay much attention to any form of agitation, pacings as well as any other form of motor activity at all.

 9. Skin and Extremities

 Skin: Take a lot of care on skin for rash, bruising or any form of injury.

 Manic Episode: Some of them are tend to suicide attempt and others are very much negligent to their personal hygiene.

 Depressive Episode: May also be slightly unattended looking or may not give attention to their hygiene.

 Nails and Hands: Try to identify any signs of bruises and other dermal cuts and injuries and other anomalies.

 Feet and Legs: The body should be checked for signs of inflammation and signs of the possible symptoms of poor blood supply.

 10. Psychological and Emotional Assessment

 Mood: Make sure that the patient knows where he/she is and what time it is.

 Manic Episode: May state they feel happy, agitated or hyperactive.

 Depressive Episode: May also have symptoms as those of depression such as low mood, helplessness or even worthlessness.

 Thought Processes: Examine for grandiose thinking or paranoid or depressive content in the thought process, as well as for derailment or a loosening of association as a formal thought disorder.

 Behavior: Check for any signs of emancipating insanity or any signs which depict how they are capable of endangering their lives.

 11. Safety and Risk Assessment

 Self-Harm: Each time, inquire if there is any notion or behavior related to self-harm or suicidal tendency.

 Risk to Others: Determine the risks of possible use of violence or harm of other people.

 12. Medication and Treatment Compliance

 Medication Review: Check whether or not the patients are on the prescribed medicine and any side effect experienced.

 Therapy: Debate participation in psychotherapy or some other sorts of treatments