5.4 Depressive Disorder and Nursing Process Flashcards
Diagnosis
Risk for suicide
Complicated Grieving
Low self esteem
Powerlessness
Spiritual Distress
Social Isolation
Disturbed thought processes
Client Outcomes
- Experienced no physical harm to self
- Discusses feelings with staff/family
- Expresses hopefulness
- Sets realistic goals for self
- No longer afraid to attempt new activities
- Interacts willingly with others
- Maintain reality orientation
- Sleeps 6-8 hours a night
Risk for suicide
- Remove potential harmful objects (glass, belts, firearms, medications)
- Maintain orders for frequent observation
- Check mouth for swallowing of medications
- Spend time with patient to convey their worth.
GOALS center around preventing self harm
Interventions - assess frequently for presence of suicidal ideation and identifying resources client can use as a support system
Complicated Grieving
- Disorder that occurs after death of a significant other where bereavement fails to meet normal expectations and causes functional impairment.
- Treatment includes identifying coping strategies, identifying clients own position in the grieving process, progression towards a resolution.
- Educate client on the stage of grief, encourage client to reach out for support
Low Self Esteem and Self-Care Deficit
Low Self Esteem - Negative feelings or self evaluation about self and self capabilities.
Self-care Deficit - Impaired ability to preform or complete ADLs for self
Treatment - Assist in ADLs, increase feelings of self-worth, help client complete ADLs independently. Therapy groups.
- Be accepting with the client
- Encourage client to recognize areas of change
- Encourage independence in preforming ADLs
Powerlessness
- Lived experience of lack of control over a situation including perception that ones actions do not significantly affect an outcome.
- Help client participate in decision making regarding their own care.
- Encourage client to take as much control over their self-care
- Discuss areas of the clients life that are within or not within the clients control
Education
- Nature of illness
- Symptoms of depression
- Management of illness
- Stress-management techniques
- Support services (suicide hotline, financial support)
Nature of Illness
- Stages of grief and symptoms of each stage
- What is depression and why people get depressed
- Symptoms of depression
Management Education
- Medication Management
- Assertive Techniques
- Stress-management techniques
- Ways to increase self-esteem
-Electroconvulsive Therapy
TREATMENTS
Individual Psychotherapy
- Focuses in clients interpersonal relations. Designed to continue working on participation of regular activities, helping resolve grief reactions, and helping client recover enhanced social function
Group Therapy
- Brings the element of peer support which provides a sense of security while embarrassing or troubling topics are discussed. Helps by linking patients up who have common problems
Family Therapy
- Similar to group therapy, helps restore adaptive family function
Cognitive Therapy
- Taught to control thought distortions considered to be part of the mood disorder
- Goals are to provide symptom relief as fast as possible
- Assist client in identifying dysfunctional patterns of thinking/behaving.
- Guide client to evidence and logic that effectively tests the validity of dysfunctional thinking
Electroconvulsive Therapy
- Induction of grand mal seizures with electrical currents to the brain
- Used for acutely suicidal patients in treatment of severe depression, especially if they are also experiencing psychotic symptoms or psychomotor retardation.
- Only used if antidepressant medication is ineffective
Side Effects - Temporary memory loss and confusion
Risks - Mortality, permanent memory loss, brain damage
Medications - Muscle relaxants and short acting anesthetics are used pre-op
