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NUR374 > Ch. 16 Depressive Disorder > Flashcards

Ch. 16 Depressive Disorder Flashcards

1
Q

mood

A

emotion that we’re feeling

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2
Q

affect

A

emotion that we’re seeing

“someone may look sad”

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3
Q

Depression is more common in

A

young women than in young men

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4
Q

anhedonia

A

loss of interest or pleasure in usual activities

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5
Q

Major Depressive Disorder

A 
Characterized by a depressive mood
Anhedonia
Symptoms present for at least 2 weeks
No history of manic behavior
Cannot be attributed to use of substances or another medical condition
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6
Q

Dysthymic Disorder

A 
"eeyore"
Sad or down in the dumps
No evidence of psychotic symptoms
Essential feature is a chronically depressed mood for: 
most of the day
more days than not
at least two years

Daily life

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7
Q

Premenstrual dysphoric disorder

A 
Depressed mood
Anxiety 
Mood swings 
Decreased interest in activities
Symptoms begin during week prior to menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses.
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8
Q

Substance-induced depressive disorder

A

Considered to be the direct result of physiological effects of a substance

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9
Q

Depressive disorder associated with another medical condition

A

Attributable to the direct physiological effects of a general medical condition

Chronic or Terminal

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10
Q

Childhood depression

A

precipitated by a loss

alleviate symptoms and strengthen coping skills

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11
Q

adolescence

A

symptoms: anger, running away, substance abuse, sexual acting out, delinquency

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12
Q

Adolescence depression

A

a visible manifestation of behavioral change that last for several weeks

treat with antidepressants

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13
Q

Antidepressants

A

BLACK BOX WARNING FOR INCREASED RISK OF SUICIDE IN CHILDREN AND ADOLESCENTS

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14
Q

Postpartum Depression

A

May last for a few weeks to several months
Associated with hormonal changes, tryptophan metabolism, or cell alterations

Treatments:
Antidepressants and psychosocial therapies

Symptoms:
Fatigue
Irritability
Loss of appetite
Sleep disturbances
Loss of libido
Concern about inability to care for infant
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15
Q

Transient depression

A

Symptoms at this level of the continuum are not necessarily dysfunctional.

the “blues”, some crying, some difficulty getting mind off one’s disappointment, feeling tired ad listless

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16
Q

Mild depression

A

Symptoms of mild depression are identified by clinicians as those associated with normal grieving.

Affective: Anger, anxiety

Behavioral: Tearful, regression

Cognitive: Preoccupied with loss

Physiological: anorexia, insomnia

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17
Q

Moderate Depression

A

Symptoms associated with dysthymic disorder

Affective: Helpless, powerless

Behavioral: Slowed physical movements, slumped posture, limited verbalization

Cognitive: Retarded thinking processes, difficulty with concentration

Physiological: Anorexia or overeating, sleep disturbance, headaches

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18
Q

Severe Depression

A

Includes symptoms of major depressive disorder and bipolar depression

Affective: feelings of total despair, worthlessness, flat affect

Behavioral: psychomotor retardation, curled-up position, absence of communication

Cognitive: prevalent delusional thinking, with delusions of persecution and somatic delusions; confusion; suicidal thoughts

Physiological: a general slow-down of the entire body

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19
Q

outcomes for the client

A

no physical harm
discuss the loss
sets realistic goals
attempts new things

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20
Q

risk for suicide

A

encourage to talk
be direct
maintain close observation

21
Q

complicated grieving

A

express emotions

crying is acceptable

22
Q

low self esteem

A

be accepting
encourage client
encourage independence to perform ADL’s

23
Q

powerlessness

A

help client set goals

encourage to take responsibility

24
Q

support services

A

suicide hotline
support groups
financial assistance

25
Q

Group Therapy

A

talk and recover

26
Q

Electroconvulsive Therapy

A

thought to increase levels of biogenic amines

27
Q

side effects of ECT

A

temporary memory loss and confusion

28
Q

risks of ECT

A

mortality, brain damage, permanent memory loss

29
Q

Psychopharmacology

A

Tricyclics
Selective serotonin reuptake inhibitors(SSRIs)
Monoamine oxidase inhibitors (MAOIs)
Serotonin-norepinephrine reuptake inhibitors

30
Q

SSRI’s( serotonin being increased)

A 
Celexa(citalopram)
Lexapro(escitalopram)
Luvox(fluvoxamine)
Paxil(paroxetine)
Prozac(fluoxetine)
Zoloft(sertraline)
31
Q

SSRI’s adverse reactions

A

sexual side effects; guys don;t want to take

dry mouth, tremor, sweating, increased anxiety(serotonin is increased)

32
Q

serotonin syndrome

A

tachycardia, fever, increased bp, tonic rigidity, seizures leading to apnea and death

33
Q

treatment of serotonin syndrome

A

receptor blockade with Cyproheptadine(Periactin) and/or Propranolol.

34
Q

SSRI teaching

A

do not discontinue suddenly bc of withdrawal

35
Q

Serotonin-norepinephrine reuptake inhibitors (new atypicals or SNRIs)

A

Work in various ways blocking the reuptake of serotonin, norepinephrine, and/or dopamine.

36
Q

cymbalta

A

SNRI: useful with comorbid pain

37
Q

Vestra

A

SNRI: depression with impaired social functioning

38
Q

Wellbutrin

A

SNRI: assistance with smoking cessation

increases risk for seizures

39
Q

Desyrel

A

SNRI: taken at night to aid with sleep

40
Q

Tricyclics (TCA)

A

Depression to target symptoms such as insomnia or anorexia

41
Q

TCA adverse reactions

A

Anticholinergic: dry mouth, blurred vision, constipation, urinary hesitancy, weight gain, postural hypotension(fall risk)

42
Q

TCA toxic effects

A

cardiac issues, dysrhythmias, MI, heart block, need full cardiac work up

43
Q

TCA client teaching

A

can take 10-14 days to work with full effect up to 6-8 weeks. dose generally taken at bedtime

do not stop suddenly

44
Q

MAOI’s

A

lowers the enzyme responsible for breaking down norepinephrine, serotonin, dopamine, and tyramine.

45
Q

MAOI’s side effects

A

Weight gain, insomnia, confusion, and hypotension (most common and normal side effect).

46
Q

MAOI: Hypertensive Crisis

A

Hypertensive crisis occurs after ingesting a substance containing tyramine. Since MAOI’s lower the enzyme for breaking down tyramine, ingesting more of it is toxic and causes the increased blood pressure that may lead to the hypertensive crisis.

Monitor blood pressure
Do not take over the counter cough medicine

47
Q

Tyramine foods

A

smoked/aged meats, sausages, cheeses, yeast, chocolate, red wine, caffeine, soy sauce, beer, figs, avocados

48
Q

Must stay on drug and dietary restrictions for how many weeks after stopping MAOI’s?

A

2 weeks

NUR374 (11 decks)

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