Mania is a serious mental health condition characterized by abnormally elevated mood, energy, and activity levels that significantly impact daily functioning. This nursing diagnosis focuses on identifying symptoms, managing behavioral manifestations, and preventing complications while ensuring patient safety.
Causes (Related to)
Mania can develop due to various factors that affect mental health and brain function:
- Bipolar disorder (primary cause)
- Substance use or withdrawal
- Medications (steroids, antidepressants)
- Medical conditions such as:
- Traumatic brain injury
- Multiple sclerosis
- Hyperthyroidism
- Brain tumors
- Environmental factors including:
- High stress levels
- Sleep deprivation
- Major life changes
- Seasonal changes
Signs and Symptoms (As evidenced by)
Mania presents with distinctive behavioral and physical manifestations that nurses must recognize for proper diagnosis and intervention.
Subjective: (Patient reports)
- Racing thoughts
- Decreased need for sleep
- Increased goal-directed activities
- Grandiose ideas
- Enhanced creativity
- Heightened sexual desire
- Excessive spending urges
- Euphoric mood
Objective: (Nurse assesses)
- Pressured speech
- Psychomotor agitation
- Flight of ideas
- Distractibility
- Poor judgment
- Impulsive behavior
- Disorganized thoughts
- Inappropriate social behavior
Expected Outcomes
The following outcomes indicate successful management of mania:
- Patient will maintain safety
- Patient will demonstrate decreased psychomotor agitation
- Patient will establish regular sleep patterns
- Patient will show improved judgment
- Patient will maintain appropriate social interactions
- Patient will adhere to medication regimen
- Patient will utilize healthy coping mechanisms
Nursing Assessment
Monitor Mental Status
- Assess mood and affect
- Evaluate thought processes
- Check orientation level
- Monitor judgment capacity
- Document behavioral changes
Evaluate Safety Risk
- Assess suicide risk
- Monitor for aggressive behavior
- Check for self-harm potential
- Evaluate environmental hazards
- Document risk factors
Assess Physical Status
- Monitor vital signs
- Check sleep patterns
- Evaluate nutritional status
- Assess hydration level
- Monitor activity level
Review Support Systems
- Evaluate family support
- Check community resources
- Assess coping mechanisms
- Document social network
- Review discharge planning
Monitor Treatment Response
- Track medication compliance
- Assess side effects
- Document therapeutic response
- Monitor mood changes
- Evaluate insight level
Nursing Care Plans
Nursing Care Plan 1: Risk for Injury
Nursing Diagnosis Statement:
Risk for Injury related to hyperactivity, impaired judgment, and excessive psychomotor activity as evidenced by agitation and impulsive behavior.
Related Factors:
- Impaired judgment
- Increased psychomotor activity
- Poor impulse control
- Sleep deprivation
Nursing Interventions and Rationales:
- Maintain safe environment
Rationale: Prevents accidental injury - Implement close observation
Rationale: Allows early intervention for unsafe behaviors - Remove potential hazards
Rationale: Reduces risk of self-harm
Desired Outcomes:
- Patient will remain free from injury
- Patient will demonstrate improved judgment
- Patient will maintain safe behavior
Nursing Care Plan 2: Disturbed Sleep Pattern
Nursing Diagnosis Statement:
Disturbed Sleep Pattern related to elevated mood and racing thoughts as evidenced by decreased need for sleep and increased activity level.
Related Factors:
- Manic episode
- Racing thoughts
- Increased energy
- Altered circadian rhythm
Nursing Interventions and Rationales:
- Establish sleep routine
Rationale: Promotes regular sleep-wake cycle - Create calming environment
Rationale: Facilitates relaxation - Monitor sleep patterns
Rationale: Tracks improvement in sleep habits
Desired Outcomes:
- Patient will establish a regular sleep pattern
- Patient will demonstrate improved rest periods
- Patient will report feeling refreshed after sleep
Nursing Care Plan 3: Impaired Social Interaction
Nursing Diagnosis Statement:
Impaired Social Interaction related to altered thought processes and excessive energy as evidenced by inappropriate social behavior and pressured speech.
Related Factors:
- Altered thought processes
- Poor impulse control
- Excessive energy
- Impaired judgment
Nursing Interventions and Rationales:
- Set clear boundaries
Rationale: Establishes appropriate social interactions - Provide structured activities
Rationale: Channels energy appropriately - Monitor social interactions
Rationale: Ensures safety and appropriateness
Desired Outcomes:
- Patient will demonstrate appropriate social interactions
- Patient will respect personal boundaries
- Patient will engage in structured activities
Nursing Care Plan 4: Ineffective Coping
Nursing Diagnosis Statement:
Ineffective Coping related to manic episode as evidenced by poor impulse control and risky behavior.
Related Factors:
- Altered mood state
- Poor impulse control
- Limited coping skills
- Overwhelming emotions
Nursing Interventions and Rationales:
- Teach coping strategies
Rationale: Provides tools for managing symptoms - Encourage healthy expression
Rationale: Promotes appropriate emotional release - Support medication compliance
Rationale: Maintains therapeutic levels
Desired Outcomes:
- Patient will utilize appropriate coping mechanisms
- Patient will demonstrate improved impulse control
- Patient will maintain medication compliance
Nursing Care Plan 5: Risk for Disturbed Thought Processes
Nursing Diagnosis Statement:
Risk for Disturbed Thought Processes related to manic episode as evidenced by flight of ideas and grandiose thinking.
Related Factors:
- Manic state
- Racing thoughts
- Altered perceptions
- Cognitive distortions
Nursing Interventions and Rationales:
- Provide reality orientation
Rationale: Maintains connection with reality - Monitor thought content
Rationale: Tracks progression of thought processes - Implement grounding techniques
Rationale: Helps focus scattered thoughts
Desired Outcomes:
- Patient will demonstrate improved thought organization
- Patient will show decreased flight of ideas
- Patient will maintain reality-based thinking
References
- Atagün Mİ, Oral T. Acute and Long Term Treatment of Manic Episodes in Bipolar Disorder. Noro Psikiyatr Ars. 2021 Sep 20;58(Suppl 1):S24-S30. doi: 10.29399/npa.27411. PMID: 34658632; PMCID: PMC8498815.
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- Fountoulakis, K., Vieta, E., Sanchez-Moreno, J., Kaprinis, S., Goikolea, J., & Kaprinis, G. (2005). Treatment guidelines for bipolar disorder: A critical review. Journal of Affective Disorders, 86(1), 1-10. https://doi.org/10.1016/j.jad.2005.01.004
- Geddes JR, Miklowitz DJ. Treatment of bipolar disorder. Lancet. 2013 May 11;381(9878):1672-82. doi: 10.1016/S0140-6736(13)60857-0. PMID: 23663953; PMCID: PMC3876031.
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