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nurs 211
mood disorders
| Question | Answer |
|---|---|
| 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
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