Templates / Bipolar disorder ATI template

Practice Management Tips

Bipolar disorder ATI template

Free PDF • 5 pages, print-ready • Clinician-reviewed

Maja Popovska Last updated October 28, 2026 Reviewed by Dr. Vanja Kitanova

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A bipolar disorder ATI template is a system disorder worksheet for nursing students. It organizes the pathophysiology, risk factors, expected findings, medications, and nursing care for a patient with bipolar disorder. Pabau's free version is a 12-section assessment form. It covers history, current symptoms, cognitive and functional testing, behavior, the treatment plan, patient education, and follow-up. Lithium levels and suicide risk have no field of their own, so this guide shows where to add them. Bipolar disorder affects roughly 2.8% of US adults each year, according to the National Institute of Mental Health (survey data from 2001-2003).

Template details

Template type

Template

Format

Printable PDF, 5 pages

Sections

8 sections

Fields to complete

76 fields

Best for

Practice Management Tips

Key takeaways

A bipolar disorder ATI template turns one patient’s mood episode into a system disorder worksheet, from DSM-5-TR diagnosis to discharge teaching.

Current FDA labeling targets a serum lithium level of 0.8 to 1.2 mEq/L for acute mania and 0.8 to 1.0 mEq/L for maintenance.

Lithium becomes toxic at 1.5 mEq/L or higher, and dehydration, NSAIDs, diuretics and ACE inhibitors all push the level up.

Mania calls for low stimulation, portable food and consistent limits, while depression calls for a suicide risk check at every contact.

Most lost marks come from generic entries, so tie every field to your patient’s own findings, labs and medications.

What is a bipolar disorder ATI template?

A bipolar disorder ATI template is a system disorder worksheet built around the ATI Active Learning format. It asks you to record the disorder’s definition, pathophysiology, risk factors, expected findings, diagnostic tests, medications, safety concerns and nursing care in one place.

Nursing programs use the format because it links cause, presentation and care in a single document. A finished template shows why a manic patient needs finger foods and why lithium levels need checking. It also shows why discharge teaching decides whether the patient comes back.

You’ll meet the condition often on a psychiatric rotation. The National Institute of Mental Health estimates, in survey data from 2001-2003, that 2.8% of US adults had bipolar disorder in the past year. Around 4.4% will have it at some point in their lives. Past-year rates peak at 4.7% among adults aged 18 to 29.

The downloadable PDF is an assessment form with 12 numbered sections. It runs from patient information and psychiatric history through cognitive, functional and behavioral assessment to the treatment plan, education, interprofessional collaboration and follow-up.

How to fill out the form on a psychiatric rotation

Work through the form in order, using your assigned patient’s chart and your course text as sources. Each step below maps to a field a clinical instructor will expect to see.

1. Record the diagnosis under alterations in health, naming bipolar I, bipolar II or cyclothymic disorder and the current episode type.
2. Describe the pathophysiology and the risk factors that apply to this patient, such as family history, substance use or missed doses.
3. List the expected findings you observed, sorted by episode type, and add the lab values that go with each medication.
4. Document medications and therapeutic procedures, flagging valproate in pregnancy and the slow titration lamotrigine needs.
5. Finish with safety considerations, nursing interventions and patient teaching, putting suicide risk first.

The PDF’s sections don’t carry ATI’s box labels, so the table below shows where each ATI heading belongs on the form.

The form has no dedicated lab box. Record lithium levels and baseline labs in Section 8, next to the drug they belong to. Your instructor can then match each value to its medication.

Completed bipolar disorder ATI template: Field-by-field overview

The table below summarizes what belongs in each field of a completed template and the level of detail instructors expect.

Pathophysiology of bipolar disorder

The exact cause of bipolar disorder is unknown, according to NIMH. Research points to differences in brain structure and function, with dysregulation of dopamine, serotonin and norepinephrine and disrupted circadian rhythms.

For the template, explain the mechanism in plain language and link it to what you saw. A patient who hasn’t slept in three nights shows the circadian piece. Rising energy and goal-directed activity reflect the excess dopamine activity linked to mania.

Risk factors for bipolar disorder

Bipolar disorder often runs in families. NIMH notes that heredity explains most of that pattern, with many genes involved and no single gene causing the disorder. Having a parent or sibling with the condition raises risk, but identical twins can still differ.

Other factors to check in the chart include the following:

• Substance use, including alcohol and stimulants, which can trigger or worsen episodes.
• Sleep disruption from shift work, travel or a new baby.
• Major stressful life events, such as a loss, a breakup or a job change.
• Stopping or skipping mood stabilizers, the most common trigger you’ll see on an inpatient unit.

Record only the factors that apply to your patient. A copied list of every possible risk factor tells your instructor you didn’t read the chart.

Diagnostic criteria for bipolar I, bipolar II and cyclothymia

DSM-5-TR separates the three main forms by the most severe episode the person has had. Use the table to pick the right label for the alterations in health box.

A manic episode needs three or more symptoms, or four if the mood is only irritable. Hypomania needs the same symptoms for at least four consecutive days, without marked impairment or hospitalization. A major depressive episode needs five symptoms lasting at least two weeks.

Expected findings by episode type

Sort your findings by episode type rather than listing every symptom of bipolar disorder. The table shows what instructors look for in each column. Describe what you observe in the domains of a mental state examination, such as speech, mood and thought process.

NIMH calls four or more mood episodes within one year rapid cycling. Note it in the template if the history shows it, because it changes the treatment plan.

Lab values and diagnostic procedures

No blood test diagnoses bipolar disorder. Labs rule out medical causes such as thyroid disease and set a baseline before mood stabilizers start. The table lists the baseline checks for the drugs you’ll see most.

Sources for the table are the FDA labels for lithium and Depakote, plus the ADA and APA consensus statement on antipsychotics. The cognitive tests in Section 5 of the PDF, such as the MMSE, belong under diagnostic procedures.

Therapeutic procedures and medications for bipolar disorder

Mood stabilizers such as lithium, valproate and lamotrigine form the core of treatment, with atypical antipsychotics used for acute episodes. Antidepressant monotherapy can trigger mania, so it isn’t presented as a first-line choice.

Lithium

The FDA prescribing information for lithium sets a target serum level of 0.8 to 1.2 mEq/L for acute manic or mixed episodes. For maintenance, the target is 0.8 to 1.0 mEq/L. Many nursing texts still quote 0.6 to 1.2 mEq/L, so use the range your program tests.

The first level is drawn after three days, 12 hours after the last dose, and regularly until the patient is stable. Levels are rechecked after any dose change, a new interacting drug, a change in exercise or a new illness.

Lithium toxicity signs

The FDA label puts toxic concentrations at 1.5 mEq/L or higher, close to the therapeutic range. Some patients show toxic signs at levels inside the range, so assess the patient as well as the number. The scale below sets the target ranges against the toxic threshold.

Course texts often split toxicity into bands by serum level, but the cutoffs differ between sources. Write the bands your program teaches, and add the nursing action: Hold the dose, notify the provider and get a stat level.

Other medications and procedures

• Valproate carries a boxed warning for liver failure, fetal harm and pancreatitis. The Depakote label reports acute mania trials dosed to trough levels of 50 to 125 mcg/mL.
• Lamotrigine is FDA-approved for maintenance treatment of bipolar I disorder. The Lamictal label warns of serious rash, including Stevens-Johnson syndrome, usually within two to eight weeks of starting.
• Atypical antipsychotics treat acute mania and some forms of bipolar depression, but they bring weight gain and metabolic risk.
• Electroconvulsive therapy is usually considered after other treatments fail, or when a rapid response is needed for suicide risk or catatonia, per NIMH.
• Psychotherapy and psychoeducation support adherence and help the patient spot relapse early.

Nursing interventions for bipolar disorder

Nursing care changes with the episode. Write interventions with a rationale for each, because instructors grade the reasoning as much as the action. If your program also asks for a nursing care plan, these interventions carry over with their rationales.

During mania

• Lower stimulation with a quiet room and few visitors. Rationale: Noise and activity feed racing thoughts and agitation.
• Offer high-calorie finger foods and fluids the patient can carry. Rationale: A manic patient rarely sits through a meal.
• Set clear, consistent limits with the same staff each shift. Rationale: Consistency reduces manipulation and splitting.
• Use short, calm, concrete sentences and redirect to solo physical activity such as walking. Rationale: It channels energy safely.
• Monitor sleep, intake, output and weight daily. Rationale: Exhaustion and dehydration raise the risk of lithium toxicity.

During depression

• Ask directly about suicidal thoughts, plans and access to means at every contact. Rationale: Asking does not plant the idea.
• Support hygiene, nutrition and sleep with small, achievable steps. Rationale: Low energy makes large tasks feel impossible.
• Watch for sudden calm or giving away belongings. Rationale: Rising energy can give a depressed patient the means to act.

Milieu safety

Keep the unit free of items that can be used for self-harm or as weapons. Check belongings on admission and remove cords, belts and sharps per facility policy.

Use the least restrictive measure first. Seclusion or restraint is a last resort, ordered and documented under facility policy, with frequent checks on the patient’s safety and needs.

Safety considerations for bipolar disorder

Suicide risk is the most serious safety concern in bipolar disorder, and it must be assessed at every contact. It rises during depressive and mixed episodes and in the early recovery period.

Escalate according to facility policy and record the patient’s own words. A written safety plan, such as the Stanley-Brown safety plan, lists warning signs, coping steps and crisis contacts. It belongs in the discharge packet.

List the drug-specific risks in the same box:

• Lithium toxicity risk rises with dehydration, fever, vomiting, diarrhea and heavy sweating.
• NSAIDs, diuretics and renin-angiotensin system antagonists such as ACE inhibitors raise lithium levels.
• Valproate should not be used in pregnancy unless other medications have failed, because it causes neural tube defects.
• Lamotrigine is stopped at the first sign of rash unless the rash is clearly unrelated to the drug.

Complications of bipolar disorder

Bipolar disorder causes heavy disability. The National Institute of Mental Health reports, in survey data from 2001-2003, that 82.9% of US adults with the condition had serious impairment. That was the highest share among mood disorders.

• Suicide and self-harm, especially during depressive and mixed episodes.
• Substance use disorder, which worsens mood stability and adherence.
• Lost jobs, debt and broken relationships from manic spending and risky behavior.
• Long-term lithium effects, including hypothyroidism, raised calcium and reduced kidney concentrating ability.
• Weight gain, diabetes and high lipids from atypical antipsychotics.

Record which complications apply to your patient and the monitoring plan for each.

Health promotion and disease prevention for bipolar disorder

Health promotion centers on keeping episodes from starting. The template should name the steps that fit your patient’s triggers.

• Keep a regular sleep and wake time, because lost sleep often comes before mania.
• Limit alcohol and avoid recreational drugs.
• Track mood daily so a shift shows up before it becomes an episode.
• Keep a written relapse plan shared with a trusted family member or friend.
• Attend every follow-up and lab appointment, even when well.

Patient education for bipolar disorder

ATI labels this box client education. It covers why medication must be taken daily during stable periods, and how to recognize early signs of an episode. Teach the patient when to seek emergency care, including any thoughts of self-harm.

Lithium teaching is where most of the detail sits. Base it on the FDA prescribing information for lithium:

• Keep a normal diet that includes salt, because a low-sodium diet raises lithium levels.
• Drink 2,500 to 3,000 mL of fluid a day, at least while the dose is being stabilized.
• Check with the provider before taking ibuprofen, naproxen, diuretics or blood pressure medication.
• Never double a missed dose, and never adjust the dose alone.
• Expect regular blood draws to check the level.
• Stop and call the provider for diarrhea, vomiting, tremor, unsteadiness, drowsiness or weakness.

Worked example: A completed template for a sample patient

The entries below show the depth a strong submission reaches for one fictional patient. The patient is a teaching composite, invented for this example.

Notice that each entry names something seen, measured or said. That specificity is what separates a top grade from a pass.

Where students lose marks on this template

Run through this checklist before you submit:

• Writing “bipolar disorder” with no type. Name bipolar I, bipolar II or cyclothymic disorder and the current episode.
• Mixing manic and depressive findings in one list. Sort them by episode type.
• Listing a lithium range with no source. Quote the range your program teaches and the timing of the blood draw.
• Leaving labs unattached. Pair each lab with the drug that needs it.
• Interventions with no rationale. Add one clause explaining why each action helps.
• Generic teaching. Include sodium, fluids and NSAIDs for any patient on lithium.
• Skipping suicide risk because the patient is manic. Record a direct assessment for every patient.

How Pabau keeps mental health assessments with the patient record

Once you’re qualified, the same assessment moves from a student worksheet to a working record. In many practices it’s still a printed PDF that gets scanned, filed and retyped into the chart.

Pabau, the therapy practice management software we build for mental health teams, turns a paper form like this into a digital form. Patients complete their history on a phone or tablet before the visit, and it lands in their patient record automatically.

Clinicians then add findings, treatment notes and follow-up plans to the same record. Automated appointment reminders help patients turn up for their medication reviews and blood draws.

Keep mood assessments with the patient record

Pabau stores intake forms, treatment notes and follow-up plans against each patient record. Your team can review a mood history in one place before every appointment.

Book a demo

Conclusion

A bipolar disorder template earns its marks in the details tied to one patient. Get the diagnosis type right, sort findings by episode, and pair every lab with the drug that needs it.

If you only polish two fields, make them safety and lithium teaching. Those are the boxes instructors read first, and they’re the ones that protect your future patients. Book a demo to see how Pabau keeps mental health assessments and follow-up plans in one patient record.

Continue your research

Writing a full care plan next? Bipolar disorder nursing care plan turns the same assessment into diagnoses, goals and evaluated interventions.

Need the drug details in one place? Mood stabilizer medication list covers doses, side effects and monitoring for each mood stabilizer.

Want to measure mania over time? Altman Self-Rating Mania Scale gives you a five-item score to track manic symptoms between visits.

Preparing a discharge safety plan? Stanley-Brown safety plan walks a patient through warning signs, coping steps and crisis contacts.

Documenting appearance, mood and thought process? Mental state examination explains how to record each domain of the exam clearly.

Frequently asked questions