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Ch. 23 (8 Q's)
Psych exam 2 depression
| Question | Answer |
|---|---|
| Mood | Pervasive and sustained emotion that colors one's perception of the world and how one functions in it. |
| Affect: | Expression of mood |
| Blunted mood | Thousand mile stare |
| Flat mood | Sadness, lacking expression, typically someone on antidepressants, long face |
| Inappropriate mood | They say they are happy yet they are crying |
| Labile mood | 0-->60 they say they are happy one minute then mad the next minute, tiniest thing can send them from happy to mad then back to happy-- unstable |
| Restricted or constricted | sad, distraught, grieved |
| Depressive disorders | A sad, irritable, or empty mood is present with somatic(body aches) and cognitive changes that interfere with functioning. |
| Disruptive mood dysregulation | Temper-tantrum- younger children if have extreme temper-tantrum that isn't congruent with their chronological age. I.e. ten year old laying in floor having a toddler tantrum |
| Major depressive disorder | When psychiatrist makes this diagnoses patient must have all the characteristics for greater than 2 weeks is a mandatory requirement |
| Persistent depressive disorder - dysthymia | Typically don't come into mental health unit. Patient doesn't know life without depression. eore donkey from winnie the poo. everything is negative |
| Premenstrual Dysphoric | all depressive symptoms, extreme, every 28 days before menstrual cycle, very irritable, and sadness |
| Substance/medication- induced | patients in recovery from substance abuse with deep dark depressive days/symptoms, no energy, can't think, sad, irritable, trying to learn new coping strategies |
| Diagnostic criteria for major depressive disorder | One or more moods (either a depressed mood or a loss of interest or pleasure) in nearly all activities for at least 2 weeks- Disruption sleep, appetite weight, concentration, energy, Psychomotor agitation, Excessive guilt/feelings worthlessness, Suicidal |
| Diagnostic criteria: Dysthymic Disorder | mood disturbance lasts more than 2 years depressed mood daily |
| Depressive disorders in children and adolescents | Anxiety and somatic (body pain) symptoms more likely Decreased interaction with peers; avoidance of play and recreational activities Irritable rather than sad mood; high risk of suicide |
| Depressive disorders in Older adults | Commonly associated with chronic illness; symptoms possibly confused with those of dementia or stroke Suicide peaks in middle age with second peak at age 75 |
| Is the following statement true or false? Children experiencing depression commonly exhibit an irritable mood? | True. Children commonly exhibit an irritable mood rather than a sad mood with depression. |
| What is the difference between anxiety and depression? | Anxiety = worry about the future Depression = worry about the past Both are treated the same though |
| True or false: Depression is twice as common in female adolescent and adult women than in adolescent and adult men? | True |
| Risk factors for depression? | Prior episode of depression, Family history of depressive disorder, Lack of social support, Lack of coping abilities, Presence of life and environmental stressors, Current substance use or abuse, Medical and/or mental illness comorbidity |
| True or false: In older adults suicide peaks in middle age with second peak at age 75? | True - there are two peaks in older adults |
| True or false: ages 18 and 29 have a three times higher prevalence of depression then those persons age 60 and older? | True - 18-->29 are 3x more likely to have depression |
| Goals of treatment | Reduce or control symptoms and, if possible, eliminate signs and symptoms of the depressive syndrome Improve occupational and psychosocial function as much as possible Reduce the likelihood of relapse and recurrence through recovery-oriented strategies |
| Priority care issues: | safety and assessment of suicide risk |
| Nursing assessment for the biologic domain? | physical systems review and thorough history of medical problems medication history physical examination neurovegetative symptoms - appetite/weight, sleep, decrease energy |
| Which of the following would a nurse identify as a neurovegetative symptom? A. Impaired occupational functioning B. Flat affect C. Disturbed sleeping D. Hyperactivity | Disturbed sleeping -Neurovegetative symptoms include appetite and weight changes; sleep disturbance; and decreased energy, tiredness, and fatigue. |
| Types of somatic therapies? | Electroconvulsive therapy (ECT) Light therapy (phototherapy) Repetitive transcranial magnetic stimulation |
| ****What is an atypical characteristic of depression syndrome? | *Overeating* or more often-not having appetite |
| ****True or false: First-line treatment antidepressant medications are SSRI and SNRIs | True: Patient needs to stay on SSRI for at least a year, won't see any results for at least 6 weeks of continuous use |
| Nursing assessments for the psychological domain? | Mood and affect Thought content Suicidal behavior Cognition and memory |
| Which of the following would the nurse be alert for in a patient receiving fluoxetine? A. Hypertensive crisis B. Sedation C. Weight gain D. Serotonin syndrome | Serotonin syndrome- Fluoxetine is an SSRI and may lead to the development of serotonin syndrome. |
| True or False? Tricyclic antidepressants (antihistaminic) are commonly associated with sedation and weight gain. | True - tricyclic -->sedation and weight gain |
| True or False? Hypertensive crisis occurs with MAOIs if they are coadministered with food or other substances containing tyramine? | True - MAOIs+tyramine = hypertensive crisis - FRESH FOOD ONLY Tyramine foods = party foods, pepperoni, alcohol, aged cheese, wines, etc. |
| Nursing Interventions for the social domain? | Milieu therapy = calm environment Safety: ↑ risk of self harm with feeling better and having increased energy Family education and support; consumer-oriented support groups |
| Is the following statement true or false? A patient with depression is at greatest risk for suicide when his or her mood is at the lowest point. | False. As patients begin to feel better and have increased energy, they may be at greater risk for suicide. When Pt at lowest point, a lot of time too tired |
| What are the goals of the continuum of care? | Maximal level of independence as possible Stability, remission, and recovery |
| Persistent depressive disorder (dysthymia) | Major depressive disorder symptoms lasting for 2 years (adult) and 1 year (children and adolescents) |
| Premenstrual dysphoric disorder | Recurring mood swings, feelings of sadness, or sensitivity to rejection in the final week prior to menses |
| Disruptive mood dysregulation disorder | Severe irritability and outbursts of temper Begins before the age of 10 Similar to pediatric bipolar disorder |
| A nurse mentions to you that she noticed her patient was started on antidepressants 2 weeks ago and has increase energy, positive sudden mood change and has begun to give away their prized belongings and appear very happy. How should you respond to this? | CAUTION! This could be a SUICIDE IDEATION! This patient may be getting ready to commit suicide and the happiness is in response to them thinking the pain and agony of living is about to come to an end. |
| What is the most important/priority nursing diagnoses for the psychological domain? | Risk for suicide! |
| Nursing assessment for the social domain? | Developmental history, family psychiatric history, patterns of relationships, support system, physical/sexual abuse, spiritual/religious background |
| Lithium Therapeutic level? | 0.6-1.2mEq/L |
| Plasma lithium level for mild SE? | <1.5mEq/L |
| Plasma lithium level in moderate toxicity? | 1.5-2.5 mEq/L |
| Plasma lithium level in Severe toxicity? | >2.5mEq/L |
| Lithium Mild SE? | Confusion Tachycardia Polyuria Polydipsia GI upset Metallic taste |
| Lithium Moderate Toxicity? | N/V Severe diarrhea Dry mouth Dizzy Ataxia Slurred speech |
| Lithium Severe Toxicity 6 signs and symptoms? | Cardiac Arrhythmias Hallucinations Oliguria Seizure Coma Death |
| MAOI should only be used when? | MAOIs should only be used "when others won't do" |
| According to Maslow's Hierarchy pyramid what is a persons most basic necessity level? | Biological and physiological (food, sleep, water) |
| According to Maslow's Hierarchy pyramid list the 5 levels from most important to least important or bottom to top of pyradmid? | 1. Physiological needs (food, sleep, water) 2. safety needs (security, employment, health) 3. love and belonging (friendships, intimacy) 4. esteem (respect, status, strength, freedom) 5. self actualization (desire to be the best one can be) |
Created by:
bolenrocks
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