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Mental Health > Chapter 17 Mood Disorders > Flashcards

Chapter 17 Mood Disorders Flashcards

1
Q

Euthymic

A

average affect and activity/ normal mood

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2
Q

Mania

A

a distinct period during which mood is abnormally and persistently elevated, expansive, and irritable.

  • Typically last about 1 week.
  • Many be longer for others.
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3
Q

Manic episodes include:

A
  • inflated self esteem or grandiosity
  • decreased sleep
  • excessive and pressured speech
  • flight of ideas
  • distractiablitly
  • increased activity or psychomotor agitation
  • excessive involvment in pleasure-seeking or risking-taking activities.
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4
Q

Manic persons moods may be:

A
  • excessively cheerful
  • enthusiastic
  • expansive
  • or irritable
  • often denies any problems
  • placing blame on others
  • also may exhibit delusions and hallucinations during a manic episode
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5
Q

Hypomania

A

period of abnormally and persistenly elevated, expansive, or irritable mood and some other milder symptoms of mania.

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6
Q

Difference between Mania and Hypomania

A

Hypomanic episodes do not impair the persons ability to function. (in fact, he or she may be quite productive) and NO psychotic feautures (delusions or hallucinations)

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7
Q

A mixed episode

A

diagnosed when the person experiences both mania and depression nearly everyday for atleast 1 week.

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8
Q

Mixed episodes are often called

A

rapid cycling

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9
Q

Bipolar I Disorder

A

one or more manic or mixed episodes usually accompanied by major depressive episodes

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10
Q

Bipolar II Disorder

A

one or more major depressive episodes accompanied by atleast one hypomanic episode.

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11
Q

Persistent depressive (dysthymic) disorder

A

a chronic,
persistent mood disturbance characterized by symp-
toms such as insomnia, loss of appetite, decreased
energy, low self-esteem, difficulty concentrating, and
feelings of sadness and hopelessness that are milder
than those of depression.

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12
Q

Disruptive mood dysregulation disorder

A

is a persistent
angry or irritable mood, punctuated by severe, recur-
rent temper outbursts that are not in keeping with the
provocation or situation, beginning before age 10.

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13
Q

Cyclothymic disorder

A

is characterized by mild mood
swings between hypomania and depression without
loss of social or occupational functioning.

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14
Q

Substance-induced depressive or bipolar disorder

A

is
characterized by a significant disturbance in mood that
is a direct physiological consequence of ingested sub-
stances such as alcohol, other drugs, or toxins.

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15
Q

Seasonal affective disorder (SAD) has two sub-types. In one, most commonly called winter depression or fall-onset SAD

A

people experience increased
sleep, appetite, and carbohydrate cravings; weight
gain; interpersonal conflict; irritability; and heaviness
in the extremities beginning in late autumn and abat-
ing in spring and summer. The other subtype, called
spring-onset SAD, is less common, with symptoms of
insomnia, weight loss, and poor appetite lasting from
late spring or early summer until early fall. SAD is often
treated with light therapy

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16
Q

Postpartum or “maternity” blues

A

is a mild, predict-
able mood disturbance occurring in the first several
days after delivery of a baby. Symptoms include la-
bile mood and affect, crying spells, sadness, insom-
nia, and anxiety. The symptoms subside without
treatment, but mothers do benefit from the support
and understanding of friends and family

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17
Q

Postpartum depression

A

is the most common complication of pregnancy in developed countries. The symptoms are consistent with
those of depression (described previously), with onset
within 4 weeks of delivery.

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18
Q

Postpartum psychosis

A

is a severe and debilitating
psychiatric illness, with acute onset in the days following childbirth. Symptoms begin with fatigue, sadness, emotional lability, poor memory, and confusion
and progress to delusions, hallucinations, poor insight and judgment, and loss of contact with reality.
This medical emergency requires immediate treat
ment. Women who have a history of serious mental
illness are at higher risk for a postpartum relapse
even il they were well during pregnancy

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19
Q

Premenstrual dysphoric disorder

A

is a severe form of
premenstrual syndrome and is defined as recurrent.
moderate psychological and physical symptoms thal
occur during the week before menses and resolving
with menstruation.somatic symptoms that can cause severe dysfunction in
social or occupational functioning, such as labile mood.
irritability, increased interpersonal conflict, difficulty
concentrating, feeling overwhelmed or unable to cope,
and feelings of anxiety, tension, or hopelessness

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20
Q

Nonsuicidal self-injury involves ..

A

deliberate, intentional
cutting, burning, scraping, hitting, or interference with
wound healing. Some persons who engage in self-injury
(sometimes called self-mutilation) report reasons of alleviation of negative emotions, self-punishment, seeking attention, or escaping a situation or responsibility.
Others report the influence of peers or the need to “fit
in” as contributing factors

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21
Q

Kindling

A

is the process by which seizure activity in a specific area of the brain is initially stimulated by reaching a
threshold of the cumulative effects of stress, low amounts
of electric impulses, or chemicals such as cocaine that sensitize nerve cells and pathways.

22
Q

Major depressive disorder

A

-typically involves 2 weeks or more
of a sad mood or lack of interest in life activities.
-four other symptoms of depression such as anhedonia and changes in weight, sleep, energy, concentration, decision-making, self-esteem, and goals, hypersomnia or insomnia, feels fatigued, changes in weight, sleep, energy, concentration, self esteem, goals, decision making. May last, weeks,Months or years if untreated
- Major depression is twice
as common in women and has a one-and-a-half to three times
greater incidence in first-degree relatives than in the general population.
-Incidence of depression decreases with age in women and increases with age in men.
-Single and divorced people have the highest incidence.
-Depression in prepubertal boys and girls occurs at an equal rate.

23
Q

psychomotor agitation

A

(increased body movements and thoughts), which includes pac-

ing, accelerated thinking, and argumentativeness.

24
Q

Ruminate

A

repeatedly going over the same thoughts

25
Q

The nurse observes that a client with bipolar disorder
is pacing in the hall, talking loudly and rapidly, and
using elaborate hand gestures. The nurse concludes
hat the client is demonstrating which?
a. Aggression
b. Anger
c. Anxiety
d. Psychomotor agitation

A

d. Psychomotor agitation

26
Q

A client with bipolar disorder begins taking lithium carbonate (lithium) 300 mg four times a day. After 3 days of therapy, the client says, “My hands are shaking.” Which is the best response by the nurse?

a. “Fine motor tremors are an early effect of lithium therapy that usually subsides in a few weeks.
b. “It is nothing to worry about unless it continues for the next month.”
c. “Tremors can be an early sign of toxicity, but we’ll keep monitoring your lithium level to make sure you’re OK.”
d. “You can expect tremors with lithium. You seem very concerned about such a small tremor.”

A

a. “Fine motor tremors are an early effect of lithium therapy that usually subsides in a few weeks.

27
Q

What are the most common types of side effects from SSRIs?

a. Dizziness, drowsiness, and dry mouth
b. Convulsions and respiratory difficulties
c. Diarrhea and weight gain
d. Jaundice and agranulocytosis

A

a. Dizziness, drowsiness, and dry mouth

28
Q

The nurse observes that a client with depression sat at a table with two other clients during lunch. Which is
the best feedback the nurse could give the client?
a. “Do you feel better after talking with others during lunch?”
b. “I’m so happy to see you interacting with other clients.”
C. “I see you were sitting with others at lunch today.”
d. “You must feel much better than you were a few days ago”

A

C. “I see you were sitting with others at lunch today.”

29
Q

Which term typifies the speech of a person in the acute phase of mania?

a. Flight of ideas
b. Psychomotor retardation
c. Hesitant
d. Mutism

A

a. Flight of ideas

30
Q

What is the rationale for a person taking lithium to have enough water and salt in his or her diet?
a. Salt and water are necessary to dilute lithium to avoid toxicity.
b. Water and salt convert lithium into a usable solute
C. Lithium is metabolized in the liver, necessitating increased water and salt.
d. Lithium is a salt that has greater affinity for receptor sites than sodium chloride.

A

d. Lithium is a salt that has greater affinity for receptor sites than sodium chloride.

31
Q

Identify the serum lithium level for maintenance and safety.

a. 0.1 to 1 mEq/L
b. 0.5 to 1.5 mEq/L
c. 10 to 50 mEg/L
d. 50 to 100 mEg/L

A

b. 0.5 to 1.5 mEq/L

32
Q

A client says to the nurse, “You are the best nurse I’ve ever met. I want you to remember me.” What is an appropriate response by the nurse?

a. “Thank you. I think you are special too”
b. “I suspect you want something from me. What is it?”
c. “You probably say that to all your nurses.”
d. “Are you thinking of suicide?”

A

d. “Are you thinking of suicide?”

33
Q

A client with mania begins dancing around the dayroom. When she twirled her skirt in front of the male clients, it was obvious she had no underwear on. The nurse distracts her and takes her to her room to put on underwear. The nurse acted as she did to

a. minimize the client’s embarrassment about her present behavior.
b. keep her from dancing with other clients.
c. avoid embarrassing the male clients who are watching.
d. teach her about proper attire and hygiene.

A

a. minimize the client’s embarrassment about her present behavior.

34
Q

Cultural Considerations in children

A

cranky, school phobia, learning disabilities, anti social, failing grades

35
Q

Cultural Considerations in adolescents

A

Risky behavior, join gangs, school dropouts, abuse substances

36
Q

ECT (electro convulsive therapy) is used when

A

drug therapy fails

37
Q

_________ is said to be best in combination with medication

A

Psychotherapy

38
Q

Data Analysis to Determine Priorities

A

Risk for suicide (safety is the first-priority)
•If suicidal, what is the plan and is it lethal, place on suicide precautions
•Imbalanced nutrition: less than body requirements
•Anxiety
•Ineffective Coping and role performance
•Self-Care Deficit
•Chronic low self esteem
•disturbed sleep pattern
•Impaired social interaction
•Hopelessnes

39
Q

Desired outcomes for client with psychomotor retardation form of depression may include:

A

The client will:
•Not injure him or herself•Independently carry out ADLs
•Establish a balance of rest, sleep and activity
•Evaluate self-attributes realistically
•Socialize with staff, peers, family/friends
•Return to occupation or school activities
•Will comply with an antidepressant regimen
•Verbalize symptoms of reoccurrence

40
Q

Client and family education for Depression

A

-Teach them that it is an illness
•Teach early signs of relapse
•Teach the importance of support groups
•Teach med compliance, therapy compliance and the importance of follow up appointments

41
Q

Lethality Assessments

A

Is there a plan?
•Is the plan possible?
•Is the plan specific?
•Is the plan lethal

42
Q

Selective serotonin reuptake inhibitors (SSRIs)

A 
Fluoxetine 
Paroxetine 
Sertraline 
Citalopram 
Escitalopram
43
Q

Tricyclic antidepressants

A

Amitriptyline
Imipramine
Mirtazapine

44
Q

Monoamine oxidase inhibitors (MAO inhibitors)

A

Phenelzine

Tranylcypromine

45
Q 
Selective serotonin reuptake inhibitors (SSRIs) Adverse reactions.
Fluoxetine 
Paroxetine 
Sertraline 
Citalopram 
Escitalopram
A 
Common s/e: Anxiety, insomnia, sedation, akathisia, sexual dysfunction. Increased risk of suicide
Serotonin syndrome (agitation, sweating, fever, tachycardia, hypotension, rigidity, hyperreflexia, confusion, ?coma and death)
46
Q 
Tricyclic antidepressants:
Amitriptyline 
Imipramine 
Tetracyclic antidepressant:
Mirtazapine 
Adverse reactions
A

Tricyclic antidepressants:
Weight gain
Anticholinergic s/e such as dry mouth, urinary retention, constipation, vision changes.

Tetracyclic antidepressant:
Serious: agranulocytosis, serotonin syndrome, orthostatic hypotension, seizures, akathisia, torsades de points, Stevens-Johnson syndrome (fever, flu-like s/s, rash, blisters, peeling of skin), rhabdomyolysis
Common: somnolence, xerostomia, increased appetite, weight gain, elevated lipids, elevated ALT, AST, photosensitivity

47
Q

Monoamine oxidase inhibitors (MAO inhibitors) Adverse reactions.
Phenelzine
Tranylcypromine

A

Sedation, insomnia, weight gain, dry mouth, orthostatic hypotension, sexual dysfunction. HTN crisis due to tyramine ingestion

48
Q

The most serious side effect of MAOIs is

A

hypertensive crisis:
life threatening conditon that can result when a client taking MAOIs ingests tyramine-containing foods and other fluids or other medications

49
Q

Hypertensive crisis symptoms

A

occipital headache, hypertension, nausea, vomiting, chills, sweating, restlessness, nuchal rigidity, dilated pupils, fever, motor agitation

50
Q

Bipolar disorder

A

involves extreme mood swings from episodes of mania to episodes of depression. (Bipolar disorder was formerly known as manic-depressive illness.) During manic phases, clients are euphoric, grandiose, energetic, and sleepless. They have poor judgment and rapid thoughts,actions, and speech. During depressed phases, mood, behavior, and thoughts are the same as in people diagnosed with major depression (see previous discussion). In fact, if a person’s first episode of bipolar illness is a depressed phase, he or she might be diagnosed with major depression; a diagnosis of bipolar disorder may not be made until the person experiences a manic episode.

51
Q

Medication for bipolar disorders

A

Lithium

52
Q

Lithium levels

A

Maintence levels: 0.5- 1
Treatment levels: 0.8-1.5
Toxic levels: 1.5 and above

Mental Health (8 decks)

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