Term
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Definition
-Symptoms represent a change from usual functioning
-Substantial pain and suffering: psychologic, social, and occupational disability
-History: one or more major depressive episodes
-No history of manic or hypomanic episodes
-Possible psychotic features
-Delusions or hallucinations
+++Last about 9 months |
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Term
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Definition
-Mood is not a change from usual behavior
-Early and insidious onset
-Chronic depressive syndrome (chronic sadness)
+++Present most of the day, more days than not, for at least 2 years |
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Term
| Who is at greater risk for a mood disorder? |
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Definition
| People with co-occurring chronic medical problems, (e.g., hypertension, backache, diabetes, heart problems, arthritis) are at a higher risk for depression than those in the general population. |
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Term
| Is depression usually a secondary or primary condition? |
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Definition
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Term
| What is depression second to in prevalence? |
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Definition
|
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Term
| Which gender is more likely to experience depression? |
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Definition
| Women are 70% more likely to experience depression than men. |
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Term
| What is important to note about seniors with MDD/DD? |
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Definition
Underdiagnosed or misdiagnosed
Diagnosed with types of dementia |
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Term
| What are the 2 most common psychiatric presentations? |
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Definition
| Mixed anxiety and depression are two of the most common psychiatric presentations. |
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Term
| What age are children diagnosed with depression? |
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Definition
| Children as young as 3 years of age have been diagnosed with depression. |
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Term
| What % of preadolescents experience MDD? |
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Definition
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Term
| What is MDD associated w/ in adolescents? |
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Definition
| often associated with substance abuse and antisocial behavior. |
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Term
| What are the genetic factors that are theorized to cause depression? |
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Definition
Genetic factors
Must interact w/ environmental and neurobiological conditions for depression to develop. |
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Term
| What are the biochemical factors that are theorized to cause depression? |
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Definition
Biochemical factors
Serotonin/norepinephrine (NE) are two major neurotransmitters involved in depression.
Both Decrease in depression |
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Term
| What are the psychosolical theories of the cause of depression? |
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Definition
The Stress–Diathesis Model of Depression
Learned helplessness
Cultural considerations |
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Term
| What is Beck's Cognitive Triad? |
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Definition
1. Negative, self-deprecating view of self
2. Pessimistic view of the world
3. Belief that negative reinforcement will continue |
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Term
| What are melancholic features of depression? |
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Definition
| complete loss of pleasure in life and inability to feel better. |
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Term
| What are atypical features of depression? |
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Definition
| Long standing sensitivity to rejection, substantial weight gain, sleeping too much, body feels weighed down |
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Term
| What are catatonic features of depression? |
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Definition
| Echopraxia, echolalia, grimacing, stereotyped movement, posturing, negativism, stupor, waxy flexibility, agistation, mutism, mannerism |
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Term
| What is postpartum depression? |
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Definition
| during pregnancy or within 4 weeks of childbirth, w/wo psychotic features, ruminations or delusional thoughts signifies an increased risk to infant. |
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Term
| What is seasonal affective disorder? |
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Definition
| – Usually begins in winter or fall and remits in the spring. Anergia, hypersomnia, overeating, weight gain, craving carbs. Light therapy. |
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Term
| What are communication guidelines used when talking to a depressed individual? |
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Definition
Person with depression may speak and comprehend very slowly.
Extreme depression—Person may be mute.
Nurses—Are uncomfortable with silence.
Sitting with a patient in silence is a valuable intervention. |
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Term
| What is the nursing diagnosis most commonly associated with depression? |
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Definition
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Term
| What are other common nursing diagnoses r/t depression? |
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Definition
Disturbed thought processes
Chronic low self-esteem
Imbalanced nutrition
Constipation
Disturbed sleep pattern
Ineffective coping
Spiritual distress
Disabled family coping |
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Term
| What is the gold standard for treatment of depression w/o psychotic features? |
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Definition
| depression but without psychotic features, a combination of specific psychotherapies (e.g., cognitive- behavioral therapy [CBT], interpersonal therapy [IPT]) and antidepressant therapy may be superior to either psychotherapy or psychopharmacologic treatment alone. |
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Term
| Mrs. Chauncey, 80 years old, is taking a selective serotonin reuptake inhibitor (SSRI) and Tylenol PM daily plus other medications. She has multiple, vague somatic complaints. This morning she complains of a “stomach ache” and “gas.” What is your best initial nursing response? |
|
Definition
D. Assess bowel sounds in all four quadrants.
Assessing bowel sounds is the best initial response. Older adults are at risk for constipation, and some medications can cause constipation. Mrs. Chauncey is taking an SSRI and Tylenol PM, which contains Benadryl. |
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Term
| What self-care assessment for nurses is necessary? |
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Definition
Self care for nurses
Self-assessment
Unrealistic expectations of self
Feeling what the patient is feeling |
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Term
| How do you assess a patients affect? |
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Definition
| restricted, flat, blunted |
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Term
| How do you assess a patient's thought process? |
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Definition
| trouble thinking, concentrating, decisions, memory |
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Term
| How do you assess a patient's mood? |
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Definition
| anhedonia, anergia, anxiety |
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Term
| How do you assess a patient's feelings? |
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Definition
| worthlessness, guilt, helplessness, hopelessness, anger, irritibility |
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Term
| How do you assess a patient's physical behavior? |
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Definition
| sad expression, poor posture, crying, flat affect, monotone, no eye contact, lethargy, fatigue, insomnia, constipation, diarrhea, pain, poor hygiene |
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Term
| How do you assess a patient's communication? |
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Definition
|
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Term
| What areas are focused on when considering suicide potential? |
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Definition
Mood
Anhedonia (inability to experience pleasure)
Anergia (lack of energy)
Anxiety
Feelings of:
Worthlessness, guilt, helplessness, and hopelessness
Anger and irritability |
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Term
|
Definition
Patient is suicidal or homicidal.
Agitation or stupor is extreme.
Life-threatening illness is a result of the refusal of foods or fluids.
History includes a poor drug response or a good ECT response.
Standard medical treatment has no effect. |
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Term
| What are other somatic treatments of depression? |
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Definition
Vagus nerve stimulation
Rapid transcranial magnetic stimulation (rTMS)
Light therapy
St. John’s wort
S-adenosylmethionine (SAMe)
Peer support
Exercise |
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Term
| Mrs. Chauncey, 80 years of age, complains of stomach pain and is now mute and staring out of her window. She is refusing food. Which of the following interventions are appropriate? Select all that apply. |
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Definition
| Mrs. Chauncey, 80 years of age, complains of stomach pain and is now mute and staring out of her window. She is refusing food. Which of the following interventions are appropriate? Select all that apply. |
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Term
| Mrs. Chauncey receives a visit from her priest. He runs out of her room and then pulls the nurse assistant back into her room. Mrs. Chauncey is cutting her left wrist (superficially) with the 5 x 7 glass from a framed photo of a grandchild. She is taken to the emergency department where her wrist is bandaged. Her daughter and son-in-law are notified. As her nurse, which of the following statements help clarify what has taken place? |
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Definition
“When your Mom’s priest arrived, he found her cutting her wrist with the glass from a framed photo
. This statement is a clear representation of what has actually happened. Once the family members understand this, then dialog related to care options can begin. |
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Term
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Definition
| Bipolar spectrum disorders are characterized by two opposite poles: mania and depression. |
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Term
| What are the specifiers of bipolar disorder? |
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Definition
Rapid-cycling bipolar disorder
Mania or hypomania with mixed features |
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Term
| What are the psychological disorders that commonly occur w/ bipolar? |
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Definition
Anxiety disorders
Panic attacks
Behavioral disorders
Substance and anxiety disorders worsen the prognosis and greatly increase the risk of suicide. |
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Term
| What are the medical disorders that commonly occur w/ bipolar? |
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Definition
Cardiovascular
Cerebrovascular
Metabolic disorders
Conditions associated with manic symptoms (e.g., central nervous system [CNS] tumors or trauma, hypothyroidism, seizure disorders, human immuno-deficiency virus [HIV]) |
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Term
| What is the goals and interventions of acute phase of mania? |
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Definition
Medical stabilization
Maintaining safety
Self-care needs |
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Term
| What is the goals and interventions of continuation phase of mania? |
|
Definition
Maintaining medication adherence
Psychoeducational teaching
Referrals |
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Term
| What are the goals and interventions of maintenance phase? |
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Definition
|
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Term
| What are the symptoms of hypomania? |
|
Definition
-Talks and jokes incessantly
-Treats everyone w/ familiarity
-Talk is often sexual
-Talk is fresh, pressured speech, one topic to another
-Full of pep and good humor
-Innapropriate intimacy with strangers
- Boundless self-confidence
-Judgement is poor
-May write large quantities of letters to rich and famous ppl
-Decreased attention span
-Overative physical behavior |
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Term
| What are the symptoms of mania? |
|
Definition
-Mood changes suddenly
-Innapropriately demanding of attention
-Profanities
-Speech includes flight of ideas
-Good humor
-Irritable
-Rage
-Grandiose plans
-Judgement is really poor
-No attention span
-No time for sex, eating, sleep etc. |
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Term
| What are the symptoms of delirious mania? |
|
Definition
-OUt of touch w/ reality
-Most likely has clang association
-May beomce destructive or aggressive
- May experience hallucinations
-Dangerous state: incoherent, extremely restless, disoriented, agitated, hyperactive motor movement. |
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Term
| How should you communicate with acute manic patients? |
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Definition
Display a firm, calm approach.
Express short, concise explanations or statements.
Remain neutral.
Maintain consistency.
Conduct frequent staff meetings to agree on approach and limit setting.
Hear and act upon legitimate complaints.
Firmly redirect energy. |
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Term
| What is seclusion milleu therapy? |
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Definition
| Control during the acute phase of hyperactive behavior almost always includes immediate treatment with an antipsychotic medication. However, when a patient is dangerously out of control, seclusion or restraints may also be indicated. |
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Term
| When should seclusion be used? |
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Definition
Reduces overwhelming environmental stimuli.
Protects a patient from harm to self or others.
Prevents the destruction property. |
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Term
| What are the interventions w/ acute mania? |
|
Definition
Structure in a safe milieu
Nutrition
Sleep
Hygiene
Elimination
BALANCE |
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Term
| What are the interventions w/ acute mania? |
|
Definition
Structure in a safe milieu
Nutrition
Sleep
Hygiene
Elimination
BALANCE |
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