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nurs 211

mood disorders

def mood; is it self or others reported self reported symptom/emotion with major influence on persons perception; self
def affect; def inappropriate; def flat; emotional reaction assoc with the experience; laughing at times of sorrow; flat when they should be smiling
what is the 4th leading cause of disability in us depression
def mania an alteration in mood that is expressed by feelings of elation, inflated self-esteem, grandiosity, hyperactivity, agitation and accelerated thinking and speaking
depression: def; it is the oldest and most frequently dx what alter in mood expressed by feelings of sadness, pessimism, despair; mental disorder;
depression: what are transient symptoms; when does pathological depression occur; with transient s/s these ppl hopefully find what type of coping mechanisms normal responses to life events; when adaptation is ineffective; positive
depression: influencing factors- would could cause this to be frequently dx; how do genetics relate to this coming dx, when going through various stages in life; 1 parent with this gives child 15-30% more of a chance to have depression
depression: in some cultures clinicians under dx what and overdx what depression and schizo- and visa versa
depression: what relationship status increases the risk single and divorced ppl
depression: what is the age of onset now 14 yo
depression: physiological influences- what meds influence it; what medical disorders; benzos, hypnotics, steroids, abx, bp meds, nsaids; parkinsons, strokes, ms, latent syphillus;
depression: physiological influences- what electrolyte issues; what hormone issues; what nutritional issues; Mag, k+, na+;wm in menopause, men with decrease in testosterone; lack of vit B, quality proteins
depression: there is a much lower relapse rate if pt takes meds only, exercise only, meds and exercise meds and exercise
depression: psychosocial theories- freud believed depression typically started after what; a loss (job, object, health);
depression: psychosocial theories- how do ppl learn this; they learn parent's reaction to what; from their parents; stressors;
depression: psychosocial theories- Sullivan believed what about object loss; that being separated or abandoned in the 1st 6 months of life and the separation leads to helplessness or despair;
depression: psychosocial theories- so the separation from parents can lead to what; hopelessness and despair;
depression: psychosocial theories- they cognitive results in what type of thinking and perceiving the environment, self and future; the cognitive needs to be changed through what type of therapy; how do repeated failures and defeat cause this negative; cognitive therapy to change those thoughts; pt will give up any other opportunity to succeed
depression: types of mood disorders: what is depressions clinical name; there is a loss of what major depressive disorder; interest and pleasure
depression: dx: person needs impaired __ for at least 2 weeks; what are impaired social occupational function take place daily for at least 2 weeks social/occupational fx; depressed mood, sleep change, cannot make decisions,
depression: Dx- this cannot be contributed to what medical conditions or substance abuse
depression: what are the 3 types; what are some psychotic features that can occur; what are some catatonic features mild, mod are severe; paranoia and hallucinations; flat depressed, stare at the wall catatonic
depression: classifications: what is melancholic; there is no response at all to anything pleasurable- super flat effect;
depression: classifications- def chronic; what is seasonal; unable to break depression for at least 2 years; when we do not see the sun for days, this can effect it;
depression: classifications: what is postpardum depression; how long is postpardum depression a risk; what are these mothers behaviors; can postpardum mom's go into psychotic states; after giving birth; up to a year; sad, irritable, hopeless, crying disconnect; yes 1-2%;
depression: classifications: what is anniversary depression this is date of significant events
children and depression: do they have anxiety of psychosis more; are the more irritable or sad; is suicide a risk; when does it peak; this is precipitated by what anxiety; irritable; yes; during mid adolescents; a loss
children and depression: what is the focus on the therapy; do they have the same s/s as adults; do they express s/s same or differently then adults alleviate s/s and strengthen coping skills; yes; differently
children and depression: what is a factor with parenting; are meds prescribed often for kids; inconsistent, poor nurturing; no they are a last resort
children and depression: s/s up to age 3; s/s age 3-5; s/s 6-8 yo; 9-12 yo; what is the common denominator for these kids; feeding problems, lack of play, tantrums; accident proneness, phobias, excessive self depreciating; vague, physical complaints, aggressiveness, clinging; morbid thoughts, excessive worry; loss
adolescence and loss: what are common normal feelings in this age; what are s/s that we need to watch for; what is common tx; sadness, anxiety, loneliness; change in school performance, inappropriate expressed anger, running away, social withdrawal, substance abuse, sexual acting out; outpatient
adolescence and loss: for girls what is different; hard to distinguish depression from normalwhat it happens more often and earlier in girls; teenage behavior
depression in the elderly: this is the most common __ disorder in elderly; what percent of US suicides are white males over age 60; they experience __ overload; are s/s same as other ages; often confused with s/s of what psych; 20%; bereavement; yes; other illnesses
def bereavement overload lots of loss in life, not able to finish grieving first stressor and then next one comes along
depression in the elderly: what are the types of tx; society values what; what is common med that is prescribed psychisoical and biological tx; vitality of youth; wellbutrin
depression: admission assessment- the assessment should be broken into how long of segments; what first should be assessed; 15-20min; biological and non-biological indicators;
depression: admission assessment- what should be focused on with the psych assessment; pt respond to assessment how; what is their behavior, are they able to interact with you, what is their concentration, are they able to sleep or eat; they are disinterested
transient depression: def; what is their affect; what is there behavior; what is their cognition; what are physical s/s; everday dissapointments in life, they are still functional; blue; tears and crying; cannot get mind off the disappointment; tired listless and no energy
mild depression: def; affect s/s; physical s/s; what do we need to teach equated with normal grieving processes; denial of grief or depression, anxious, anger,agitation, tearful; eating too much or not enough, somatic complaints; grief responses
moderate depression: def; what is behavior; what is cognition; what are physical s/s equates with dystonia and is a chronic course of depression-they are not as happy as they could be but not as depressed either; slow; slower thinking process; HA and backache
moderate depression: often times they are resistant to what; what biological markers help docs know what meds to give patient; can these ppl manage their life; are they able to interact in life to prevent those behaviors in their kids meds and they will end up using antipsycotics; CYP450; yes; no
severe major depression: this is aka; def affect; s/s behavior; what is cognition; what are physical s/s major depressive disorder; total despair,worthlessness,nothing to live for; severepsychomotor retardation, little communication; delusional thinking of persecution, suicidal ideation; complete slow down of the entire bofy
Grief response: def; what are forms of loss; loss is experienced in which an individual relinquishes a connection to a valued object; significant other, through illness, decreased self-esteem, material extensions of self
what are factors that influence grief importance, degree of dependence, degree of ambivalence, other relationships, past grief response, age of lost person, health of mourner, degree of preparation, for loss or anticipatory grief
maladaptive grief: def delayed or inhibited grief; def prolonged grief; no grieving when loss occurs, overreaction to others loss; no resumption of normal activities within 4-8 wks of a loss-seems sort timing
maladaptive grief: exaggerated grief response: def distorted grief reaction in which symptoms may be exaggerated - this can be cultural and individualized
suicide: what percent are dx with a mental disorder; who is at risk; single or married ppl; what does freud say about suicide >90%; threat to depressed pts; single; it is because of an inner self hate
suicide: how does religion influence it; how does socioeconomic status effect it affiliation with a religious group decreases risk of suicide; individuals in the very lowest and highest classes have higher suicide rates
suicide: what race is at the highest risk in America; what race is the second highest risk whites; native americans
suicide: what psych illness is the most common one the precede suicide; what personality disorder increases the risk; what other psych issues precede this mood disorders; borderline; substance abuse, schizo, anxiety, severe insomnia
suicide: how is it r/t age; the older someone gets the more change that they will commit suicide;
suicide: assessment- assess risk of self ___; what exam should be done; assess prior hx of what; assess what event harm; medical and neuro; mental health tx; triggering event
suicide: risk for suicide r/t what depressed mood, feelings of worthlessness, anger turned inward on the self
grief: nursing dx dysfunctional grieving r/t what real or perceived loss, bereavement overload, evidenced by denial of loss, inappropriate expression of anger, idealization of or obsession with lost object
suicide: nursing dx low self esteem r/t learned helplessness, feelings of abandonment by significant other, impaired cognition fostering negative view of self
client and family education nature of illness, teach the stages of illness and grief, management of the illness, meds, cognitive therapy, support groups, support services
tx for mood disorders: what is psych treatment; individual psychotherapy, group therapy, light therapy;
tx for mood disorders: transcranial magnetic stimulation- def they go everyday and there is no physical touching of the scalp
tx for mood disorders: ECT- intitiates ___ by electrical current; what is given so pt does not have pain or violent seizure; how often is it done; produces rapids relief of what generalized seizure; anesthetic and muscle relaxant; 2-3 times/ week; depression
tx for mood disorders: ect contraindications- what in brain; increased ICP, brain tumor or CVA, cardiac, severe osteoporosis, pulmonary disorders, pregnancy
tx for mood disorders: meds what are used; antidepressants,
serotonin syndrome- most likely in pts taking how many serotonin antogonists; mild or severe; what is onset- rapid or slow; 2 or more; mild but can cause death; rapid;
MAO inhibitors: blocks what enzyme; monoamine oxidase is the primary purpose to metabolize what; this med can cause what crisis; what is not oxidized when taking this med; without oxidizing tyramine this increases levels of what in body monoamine oxidase; neurotransmitters; HTN crisis; tyramine; epinephrine
increased epinephrine leads to what HTN
tricylcin antidepressents: there is a high or low anticholinergic effect; why is it given at night high; bc of the sedating effect
Bipolor disorder: the mood swings from what extremes; there is intervening periods of what; what is the genetic link depression to extreme euphoria; normalcy; 28% if one parent
Bipolar disorder: etiological implications- what are the biological theories; what are biochemical influences; what are physical influences; strong hereditary implications; possible excess or norepinephrine and dopamine; brain lesion, medication side effects
Bipolar disorder: etiological implications- who has more of a change to get it men or women; women
Bipolar disorder: s/s: what is labile; they have what 2 e words; they have non stop chatter aka; when very manic they have what type of delusions; how is sleep when manin; mood; euphoria and elation; loguaciousness; grandioses; little to none;
Bipolar disorder: s/s- what is unihibted; what is energy; what is dress; what is psychomotor activity sexuality; neverending; disorganized, flamboyant and bizarre;
Bipolar disorder: bipolar 1- combo of what two things; where do they lie on the spectrum; they reapidly alternate between what; o major depression and full manic episodes; anywhere; manic and depressive
Bipolar disorder: Bipolar 2- combo of what 2 things; do they ever make it to the full criteria of mania major depression and hypomania; no
hypomania: what is mood; what is cognition; what is activity, cheerful, a little irritable, volitle, mood can fluctuate; marcasistic, great worth and abilities, goal directed behaviors are difficult; extroverts, social, not much depth, spend money, laugh inappropriately
acute mania: what is mood; what is cognition; what is activity constent high, very irritable; psychotic features, paranoia, pressured speech, abruptly change topics; attention diverted easily, psychomotor excessive energy, sexual interests increase,
risks for bipolar could be taken advantage of, divorce rate high, they do not have employment
delirious mania: what is mood; why do we not want them to get to this state profoundly irritable and disorganized, very agitated, will physiologically wear out; it is a safety risk
bipolar in children: characterized by what; s/s reflect what; when is their first contact with the mental health agency intense rage episodes for 2-3 hours; the developmental level of the child; 5-10 yrs;
bipolar in the elderly: what is supposed to cause it; when was it recognized in the elderly more neurological abnormalities and cognitive disturbances; just recently
bipolar: nursing dx- risk for injury r/t; they have lack of control over what r/t extreme hyperactivity evidencedby increased agitation; purposeless and potential injurious movements
bipolar: nursing dx- why is there impaired social interaction r/t; egocentric and marcissistic behavior;
bipolar: nursing dx- there is disturbed sleep pattern r/t what excessive hyperactivity and agitation;
bipolar: what meds are used lithium carbonate, clonazepam, valproic acid, betablockers, antipsychotics
antimanic drugs: lithium- this enhances the reuptake of what 2 neurotransmitters in the brain; when it enhances these two neurotransmitters what happens to body norepi and serotonin; to decrease the levels of it and results in decreased hyperactivity
antimanic drugs: lithium- what is therapeutic range; how long does it take for optimal effectiveness 06.-1.2 ; 7-10 days;
antimanic drugs: lithium- what is intitial dose; why are divided doses not a good idea 600-900 mg/ day; they are harder on renal and cause more nausea and tremors
antimanic drugs: lithium toxicity- s/s in GI; what is s/s in senses; what are neuro s/s; what are cardiac s/s;what are GU s/s n/v and D; blurry vision,tinnitus; increased tremors, confusion, seizures; oliguria, anuria; arrhythmias, MI
antimanic drugs: lithium- teach what contact casemanager if toxics/s appear, get regular levels done, maintain sodium levels, maintain 2-3 liters of water a day
bipolar teach individual, group and family, cognitive therapy, ECT, support groups
dysthymic disorder: similar but milder then what; when is early onset; they describe their mood as what; s/s major depression; <21; down in the dumps; low apetite, overeating, insomnia, low energy, low self esteem, hypersomnia, poor concentration, feelings of hopelessness
bipolar: are delusions always part of it; no;
cyclothymic: this is what; a chronic mood disturbance of at least 2 yr duration numerous episodes ofhypomania and dpepressed mood of insufficient severity or duration to meet criteria for bipolar 1 or 2;
Created by: jmkettel