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Test 4-2381
Mood disorders.Depression/bipolar disorders-char ch 18,19,32-11/18
| Question | Answer |
|---|---|
| What are two assessment tools for depression? | Beck depression inventory, zung's self-rating depression scale |
| Approximately 2/3 of suicidal peole contemplate suicide and __% actually follow through. | 15% |
| 4 main areas to assess with depression: | mood, physical changes, vegatative signs and cognition |
| Aspects of mood I should assess (depression) | anhedonia, angergia (lack of energy), anxiety, feelings of worthlessnes, guilt, helplessness, anger and irritability |
| Physical changes to observe (depression) | posture, facial expressions, sadness and dejection, weeping or cant, no eye contact or monotone voice, flat affect, yes/no responses (poverty of speeech)psychomotor retardation/agitation |
| Vegitative signs to observe (snap shot of depression) | eating changes, sleeping (early waking or in the night) elimination (constipation) sexuality, self care |
| Cognition to observe (depression) | slow thinking, memory/cog affected, dwell on faults & fail to recognize strengths, poor judgement, indecisive, delusional (wicked so should die) |
| What else should I assess for with a depressed patient? | med & neuro eval, Hx of depression, supports, trigger event, cultural beliefs about mental health and spiritual practices |
| Depressed patients, do they like change? Do they seem to respond to nursing interventions? | no |
| What emotions do nurses experience when working with depressed patients? | frustration, hopelessness, annoyance, angry, hurt, anxious and incompetent. |
| Who do psyche nurses have unrealistic expectations for? | patients and self |
| What do nurses need to remember about patients depression? | it has a lot to do with neurotransmitters |
| What nursing diagnoses have to do with the vegetative signs? | imbalanced nutrition, disturbed sleep pattern, constipation, sexual dysfunction. |
| What is a basic level intervention with a depressed person? | silence, open statements, concrete words, time for patient, listen for covert messages, ask about suicide plans and avoid trite remarks |
| With a depressed patient help identify: | cognitive distortions and negative distortions |
| exercise, supportive relationships and spiritual referrals can help patients with | depression |
| Help depressed patients by questioning their underlying beliefs and consider alternative | explainations |
| what teaching is important for family and individual faced with depression | teach about biological Sx, psychosocial/cog changes, suicide s/s, meds, aftercare and relapse prevention |
| for patients who aren't eating: | increase high protien snacks and drinks and fluids. Encourage family to bring in thier favorite foods. |
| What can I do for sleep patterns of a depressed person? | provide restful environment at night and encourage being awake in the day |
| Self care for a depressed person: | encourage ADL's, may need step by step. |
| what are suicide precautions? | 15 min checks, scrubs, and 1:1's |
| What items are restricted on a psyche floor? | plastic bags, shoe laces or belts, no cords of any kind, hair appliances with supervision |
| What are the four main charicteristics of mania? | mood, behavior, thought processes, and cognitive function |
| Bipolar mood is | euphoric labile, get rich schemes, or desire for power, paranoid and hostile |
| Bipolar behavior is: | hyperactive, grandiose, finanial issues, manipulative, busy, poor concentration, starts many projects yet finishes few, highly distractible |
| Thought processes of bipolar: | flight of ideas, rapid speech, circumstancial communication (polititian), verbosity (constant talk), clang associations, grandiousity |
| Cognitive function of a person with bipolar | onset preceded by high cognitive fxn., 1/3 of pts. have cog issues, verbal mem/sustained attn. contributes to relational trouble |
| other assessments for bipolar: | danger to self and others?, hosp. needed?, medical causes? (thyroid, lupus)dehydration, exhaustion, cardiac collapse?, families understanding |
| bipoler possible dx: | risk 4 injury, coping, r/f violence, impaired communication, isolation, nutrition, sleep, self care deficit etc. |
| Phases of bipolar treatment: | phase one:acute prevent injury (2-6 months)phase two: continuation of treatment lasts 4-9 months, with relapse prevention andphase 3-maintenance treatment phase (begins at about 6 months) |
| Phase one for bipolar (prevent injury): | hydrate w/in 24 hrs, maintain cardiac status, maintain tissue integrity, sufficient sleep and 10 min rest every hour, encourage self control, medicate if needed |
| Phase two for bipolar (cont. of Treatment) | education for pt. and family includes:disease, signs of relapse, meds, substance addiction info |
| What kinds of pychosocial interventions are there for bipolar | support groups (critical), CBT for coping skills, communication and problem solving skills training. |
| Phase three for bipolar (maintenance treatment phase) | med compliance is big, community resources such as NAMI, follow up with provider (lithium levels) |
| NAMI | national alliance 4 the mentally ill |
| Health teaching for a bipolar person focuses on: | med compliance & follow up, Sx of impending episodes, regular eating,sleeping and exercize, day hospitalization or home care, NAMI or Manic Depression organization |
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