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mood disorders

slide guide

QuestionAnswer
What is the object loss theory with depression? suggests that depressive illness occurs as a result of having been abandoned by or otherwise separated from a significant other during the first 6 months of life. mother is object. rejection=depression
What is the learned helplessness theory with depression? exists in humans who have experienced numerous failures (either real or perceived). The individual abandons any further attempt to succeed. depressed cause doesnt feel has contol.
What is the cognitive theory for depression? cognitive distortions lead to depression: 1. Negative expectations of the environment 2. Negative expectations of the self 3. Negative expectations of the future
What are some examples of affective aspects of depression? Anxiety, apathy, helplessness, hopelessness, sense of personal worthlessness, guilt
What are some examples of physiological aspects of depression? Somatic signs: Backache, anorexia, chest pain, dizziness, nausea, insomnia, sleep disturbances, weight change
What are some examples of cognitive aspects of depression? Confusion, ambivalence, indecisiveness, pessimism, self-deprecation, self-destructive thoughts
What are some examples of behavioral aspects of depression? Aggressiveness, agitation, alcoholism, intolerance, poor personal hygiene, tearfulness, withdrawal
What does transient depression look like? having "the blues, lethargy, some crying, thinking about disappointments
What does mild depression look like? denial of feelings, anorexia/overeating,HA, insomia/hypersom, ambivalence, tearfulness, self-blame or others
What does moderate depression look like? sadness, dejection, pessimistic,feel powerless, chest pain, SI, obsessive thoughts/cant concentration, less hygiene
What does severe depression look like? total despair, flat affect, sluggish digestion/urinations, weight loss, hallucinations, SI, slumped posture, no hygiene
What are the symptoms of Major Depression? Must have Depressed mood, lost interest/pleasure and change in weight, sleep issues, fatigue, feel worthless, cant concentrate, thoughts of death/SI, NO mania present
What are symptoms of Dysthymic Disorder? Slightly milder than MDD but it is *chronically depressed, NO psychotic symptoms, fatigue,sleep problems
What is always the nursing priority for depression? Risk for suicide r/t feelings of hopelessness and desperation Always worry about safety first!!
What are some nursing diagnoses? Ineffective coping r/t grieving Complicated grieving r/t real or perceived loss Constipation r/t inactivity, decreased fluid intake Fatigue r/t psychological demands Self neglect r/t depression, cognitive impairment
What are outcomes for depression? Experience no physical harm to self. Discuss loss with staff and/or family. Sets realistic goals for self. Interacts willingly and appropriately with others. Is able to maintain reality orientation, sleep, bathe, groom
Nursing interventions for depression? Demonstrate honesty, empathy, compassion Avoid overaggressive or lighthearted approach Establish rapport by sharing time together Focus on strengths & accomplishments Encourage client to express honest feeling encourage self care, asesss for SI
A RN can best demonstrate empathy by: conveying genuine understanding of the clients problems
A patient is considering ECT and questions the nurse about the side effects of treatment. What is the nurses response common side effects are transient memory loss and confusion i
What is bipolar disorder? Cycles of depression and mania which looks like: inflated self-esteem, dont need sleep, flight of idea, risk behaviors that are pleasurable, racing thoughts
What is the Hypomania stage? disturbance is not sufficiently severe to cause marked impairment in social or occupational functioning or to require hospitalization The person is cheerful but can get irritated quick if you dont fufill wishes, easily distracted and talk is loud/inappr
What is Acute Mania stage? experience marked impairment in functioning, euphoria easily changes to anger/sadness, flight of ideas, poor impulse control in spending money and sex, dress/hygiene change
What is delirious mania? very labile mood-despair to esctasy, delusion of granduer, risk of injury to self- rarely gets to this state because of meds.
What is Bipolar I? an individual who is experiencing, or has experienced, a full syndrome of manic or mixed symptoms
What is Bipolar II? characterized by recurrent bouts of major depression with episodic occurrence of hypomania. The individual who is assigned this diagnosis may present with symptoms (or history) of depression or hypomania. has never had full mania.
What is Cyclothymic Disorder? Disorder-chronic mood disturbance of at least a 2-year duration involving numerous episodes of hypomania and depressed mood of insufficient severity or duration to meet the criteria for either bipolar I or II disorder
What are some nursing diagnoses for Bipolar? Risk for injury r/t extreme hyperactivity Risk for violence: self-directed or other-directed r/t next 2 items Disturbed thought processes (delusions) Ineffective activity planning r/t unrealistic perception of events
A patient diagnosed with bi-polar has been hospitalized for 2 weeks asks if they are ever going leave Tell me more about your feelings about being hospitalized
What are some outcomes for bipolar? Not harm self or others. Interacts appropriately with others. Verbalizes accurate perception of environment. Does not manipulate others for gratification of own needs. Bath, groom, sleep without direction
A client diagnosed with bipolar mania is wearing a revealing oufit, nurse should Quietly walk her back to her room and help her change
Nursing interventions for Bipolar? simple explanations and concise, truthful answers to questions Maintain and convey a calm attitude Set constructive limitsprevent manipulation of others Point out positive aspects of client’s behavior and accomplishments Reduce stimuli snack on the r
What are some interventions to prevent violence on the unit? enough staff for 1-1, i.d.escalation&use prn meds, quiet place for agitated pts, effective communication, individualize tx plan
What are common meds for depression? Tricyclic, SSRIs, MAOIs
What are common meds for bipolar? Mood stabilizers
What are common therapies for both depression and bipolar? Individual psychotherapy Group therapy Family therapy Cognitive therapy Electroconvulsive therapy Psychopharmacology
What are reason people with Bipolar dont take meds? Forgetting to take medications Side effects (feared & real) Disorganized home environment Insufficient information regarding bipolar disorder and treatment Social network advised against medication Problems paying for medications
What are common ages, gender and ethnicities, marital status that are more at risk for suicide? Age: over 50 or teenagers Gender: males Ethnic : White, then NA, then AA Marital stats: Single or Divorced
What are other risks for SI? loss of job, isolated, has a weapon, SA or MH issues, dont want help cause of stigma
what are some protective factors from SI? good coping skills, married/family support, getting help for SA/MH currently, religious or culutural beliefs that are against SI
What population should you assess for SI? Veterans - they have access to weapons, hx of PTSD, amy be reluctant to get help
What questions should you ask when assessing suicide? thinking of harming self ? and do you have plan? be matter of fact, encourage expression of feelings, supportive
When is SI assessment needed? when go into MH clinic, when you see clues of possible SI (giving away things, etc). When someone says "I want to die","nothing matters anymore"
What are nursing diagnoses for SI? Risk suicide r/t depressed mood, (with Major Depressive Disorder, Dysthymic Disorder, Bipolar I Disorder) Risk for self-inflicted injury r/t stated desire to die, threats to kill,SA Hopelessness r/t absence of support systems
What are some outcomes for SI? Not harm self. Disclose suicidal ideas if present and seek help. Maintain connectedness in relationships. Talk about feelings. Set realistic goals for self
What are best practice guidlines for SI? Take seriously all statements made about wanting to die/ being at risk Ensure observation & therapeutic engagement Foster hope with the suicidal client. Assess/manage factors physical safety of client/tx team. minimize guilt with SI/MH
What are other nursing interventions? no harm contract, resources for client when in crisis again, make irregular rounds so they dont know when to expect you, encourage talking about feelings. find out whats behind SI?
When working with patient with mood disorders remember to: do self assessment of any assumptions, values, etc that may interfere with giving proper care.
Created by: UARN85