Ch 17 Mood Disorders/Suicide Book Key Points Flashcards
Studies have found a ___ component to mood disorders.
genetic
The incidence of depression is up to three times greater in first-degree relatives of people with diagnosed depression. People with bipolar disorder usually have a blood relative with bipolar disorder.
Only 9% of people with mood disorders exhibit __.
psychosis
Major depression is a mood disorder that:
robs the person of joy, self- esteem, and energy.
It interferes with relationships and occupational productivity.
Symptoms of depression include:
sadness, disinterest in previously pleasurable activities, crying, lack of motivation, asocial behavior, and psychomotor retardation (slow thinking, talking, and movement).
Sleep disturbances, somatic complaints, loss of energy, change in weight, and a sense of worthlessness are other common features.
Several antidepressants are used to treat depression:
SSRIs have the fewest side effects.
Tricyclic antidepressants are older and have a longer lag period before reaching adequate serum levels; they are the least expensive type.
MAOIs are used least because clients are at risk for hypertensive crisis if they ingest tyramine-rich foods and fluids while taking these drugs. MAOIs also have a lag period before reaching adequate serum levels.
People with bipolar disorder cycle between:
mania, normalcy, and depression. They may also cycle only between mania and normalcy or between depression and normalcy.
Clients with mania have:
a labile mood, are grandiose and manipulative, have high self-esteem, and believe they are capable of anything. They sleep little, are always in frantic motion, invade others’ boundaries, cannot sit still, and start many tasks. Speech is rapid and pressured, reflects rapid thinking, and may be circumstantial and tangential with features of rhyming, punning, and flight of ideas. Clients show poor judgment with little sense of safety needs and take physical, financial, occupational, or interpersonal risks.
___ is used to treat bipolar disorder. Other antimanic drugs include sodium valproate, carbamazepine, other anticonvulsants, and clonazepam, which is also a benzodiazepine.
Lithium
It is helpful for bipolar mania and can partially or completely eradicate cycling toward bipolar depression. Lithium is effective in 75% of clients but has a narrow range of safety; thus, ongoing monitoring of serum lithium levels is necessary to establish efficacy while preventing toxicity. Clients taking lithium must ingest adequate salt and water to avoid overdosing or underdosing because lithium salt uses the same postsynaptic receptor sites as sodium chloride does.
For clients with mania, the nurse must monitor:
food and fluid intake, rest and sleep, and behavior with a focus on safety until medications reduce the acute stage and clients resume responsibility for themselves.
___ means thinking of suicide.
Suicidal ideation
People with increased rates of suicide include:
single adults, divorced men, adolescents, older adults, the very poor or very wealthy, urban dwellers, migrants, students, whites, people with mood disorders, substance abusers, people with medical or personality disorders, and people with psychosis.
The nurse must be alert to clues to a client’s:
suicidal intent—both direct (making threats of suicide) and indirect (giving away prized possessions, putting his or her life in order, making vague goodbyes).
Conducting a suicide lethality assessment involves:
determining the degree to which the person has planned his or her death, including time, method, tools, place, person to find the body, reason, and funeral plans.
Nursing interventions for a client at risk for suicide involve:
keeping the person safe by instituting a no-suicide contract, ensuring close supervision, and removing objects that the person could use to commit suicide.
