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Psychosocial > Depression > Flashcards

Depression Flashcards

1
Q

What is mood?

A

A pervasive and sustained emotion that influences ones perception of the world and how one functions

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2
Q

What is affect?

A

Outward emotional expression

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3
Q

What are examples of affect?

A

Blunted, bright, flat, inappropriate, labile, restricted

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4
Q

What is depression?

A

A mental state characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration

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5
Q

Depressive disorders affect who (general) and how do they affect them?

A

Kids and adults; somatic & cognitive changes, lower quality of life, premature death/suicide, sleeping, concentration, weight, agitation, decreased sexual desire

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6
Q

Who is depression most common in?

A

Females, 18-29 y/o

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7
Q

If a kid is suspected of having a depressive disorder, how might they present?

A

With somatic issues like a stomach ache or headaches, less interactions with peers, avoid play and recreations that they previously liked, irritable instead of sad.

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8
Q

What is a new depressive disorder diagnostic in the DSM-5?

A

Disruptive mood dysregulation

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9
Q

T/F people with depressive disorder experience a low quality of life and are at greater risk for physical health problems

A

True

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10
Q

Chronic victimization and substance abuse increases the risk of what in kids?

A

Depression, suicide ideation, and suicide attempts

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11
Q

How can we treat these side effects of antidepressants:
dry/inflammed mouth and caries

A

Sugarless gum and candies, 6-8 cups water, toothpaste for dry mouth, pilocarpine drops

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12
Q

How can we treat these side effects of antidepressants:
nausea, vomiting

A

Take med with food (crackers, toast, tea) or change medications

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13
Q

How can we treat these side effects of antidepressants:
weight gain

A

Balanced diet and exercise regularly. Can also change medicines

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14
Q

How can we treat these side effects of antidepressants:
urinary hesitation and consitpation

A

6–8 cups of water per day, bulk laxative, daily exercise, 6–8 cups of water per day, diet rich in fresh fruits, vegetables, and whole grains

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15
Q

How can we treat these side effects of antidepressants: diarrhea

A

Maintain fluid intake, OTC antidiarrheal

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16
Q

How can we treat these side effects of antidepressants:
drowsiness

A

Don’t drive when drowsy, plan for rest time, no alcohol, shift dosing time, lower medication dose

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17
Q

How can we treat these side effects of antidepressants: fatigue

A

Daily exercise

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18
Q

How can we treat these side effects of antidepressants: Blurred vision

A

Pilocarpine drops, magnifying glass

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19
Q

How can we treat these side effects of antidepressants: flushing and sweating

A

Frequent baths, lightweight clothing, Terazosin once daily

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20
Q

T/F: depression in older adults is often undetected or inadequately treated

A

True

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21
Q

Depression in older adults is often associated with what chronic illnesses

A

Heart disease, stroke, and cancer

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22
Q

In older adults, what can depressive symptoms be confused with?

A

Bipolar, dementia, and cerebrovascular symptoms

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23
Q

Suicide is a high risk for the older population, but specifically…. (men or women)

A

Men and people 75 or older

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24
Q

Major depressive disorder diagnostic criteria

A

1 or more moods; depressed or loss of interest/pleasure in nearly all activities for 2 weeks. 4 of 7 symptoms must be present: disruption of sleep, appetite, concentration, energy, psychomotor agitation, excessive guilt, worthlessness, suicidal ideation

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25
Q

Major depressive disorder diagnostic criteria

A

1 or more moods; depressed or loss of interest/pleasure in nearly all activities for 2 weeks. 4 of 7 symptoms must be present: disruption of sleep, appetite, concentration, energy, psychomotor agitation, excessive guilt, worthlessness, suicidal ideation

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26
Q

What groups have higher incidences of depression? White, black, Asian, hispanic, or native americans?

A

White, native americans

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27
Q

Name 2 risk factors for depression

A

Prior episodes, family history, lack of social support, lack of coping abilities, environmental stressors, substance use and abuse, medical/mental illness comorbidity

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28
Q

What word do native americans and middle eastern use to describe depression?

A

heartbrokenness

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29
Q

Someone from the West Indies would use what word in-place of depression?

A

brain fog

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30
Q

Zar and running amok describe what?

A

Depressed, sad, hopeless, and discouraged

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31
Q

According to neurobiology theories, depression is caused by what?

A

A deficiency or dysregulation in the CNS concentrations of serotonin, dopamine, and norepinephrine

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32
Q

Psychoneuroimmunology

A

Research into proteins, known as chemical messengers, between nerve cells. Increased cytokine levels are associated w/depression and cognition impairment= inflammatory rxn are involved in development of mental health disorders

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33
Q

Freuds view on depression

A

Due to an early lack of love, care, warmth, protection which results in anger, guilt, helplessness, and fear regarding the loss of love

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34
Q

The conflict between wanting to be loved and the fear of rejection leads to….

A

Self-punishment, self-rejection, low self-esteem, and depression

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35
Q

Developmental theorists think that depression results from…

A

Loss of a parent through death, separation, or lack of emotionally adequate parenting which delays developmental milestones

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36
Q

What are the 3 specific goals of depression treatment?

A

1) reduce/control/eliminate symptoms
2) improve occupational and psychosocial function
3) reduce relapse through recovery-oriented strategies

37
Q

What 2 types of theories have been shown to be as effective as pharmacotherapy in milder depressions?

A

-Cognitive: prevents relapse and is implemented by a trained professional
- Interpersonal: recognizes and seeks to overcome losses, role confusion, social isolation, and deficits in social skills

38
Q

Combination therapy is usually effective. If not, what can be done in-place of that?

A

ECT, light therapy, rTMS

39
Q

What are alternative therapies?

A

Acupuncture, yoga, tai chi, meditation, guided imagery, massage therapy, music/art therapy

40
Q

Would interviewing a family member or friend about the patients day-to-day life help with diagnosis?

A

Yes

41
Q

Past history assessment for depression

A

CNS, endocrine, anemia, chronic pain, autoimmune illness, diabetes, menopause, surgery, abortion, child birth,

42
Q

Physical assessment for depression

A

VS, CBC, LFT, EKG, urinalysis, appetite and weight changes, sleep disturbances, tiredness, decreased energy, and fatigue

43
Q

Hypersomnia

A

Prolonged sleep episodes at night or increased daytime sleep. Pt complains of not feeling rested

44
Q

Terminal insomnia

A

Waking too early and not being able to go back to sleep. Pt complains of not feeling rested

45
Q

What should the nurse gather information on related to medications during the assessment?

A

Frequency and dosage, prescribed/OTC meds, assess lethality of meds, herbal intakes, drugs,

46
Q

What is included in the psychosocial assessment?

A

Mental status exam, coping skills, developmental history, family history, patterns of relationships, support system, education/work history, history of abuse. Identify pt strengths and weakness, include fam member in interview.

47
Q

Anhedonia

A

Loss of interest or pleasure

48
Q

What are the 5 common self-report scales for depression and assessing mood/affect?

A

-GQH (get health questionnaire)
-CES-D
-BDI (beck depression inventory)
-SDS
-PRIME-MD

49
Q

Psuedodementia

A

Memory difficulties which are signs of depression in older adults but commonly mistaken for dementia

50
Q

Suicidal behavior

A

Occurrence of persistent thought patterns and actions that indicate a person is thinking about, planning, or enacting suicide

51
Q

Children most often use ____ as their method of suicide compared to men using ___ and women using ___

A
  • suffocation
  • firearms
  • pills, poison
52
Q

How can the nurse prioritize care with depression?

A

1- assess suicide
2- physical impact of depression

53
Q

What are some blocks to communication when dealing with someone who is depression?

A

Being overly cheerful or cheerleading. Instead, be calm and supportive

54
Q

What is one of the 1st nursing interventions in physical care?

A

Re-establish normal sleep patterns and healthy nutrition

55
Q

Patients with coronary heart disease can do what to help decrease depressive symptoms within 4 weeks?

A

Deep breathing exercises 3 times a day

56
Q

Meds should be continued for at least ___ months to ___ year after the pt achieves complete remission of symptoms

A

6 months
1 year

57
Q

What 3 classes of meds commonly have an impact on vital signs?

A

MAOIs, TCAs, or SNRIs

58
Q

Why do people stop taking their SSRIs?

A

GI (cramping, diarrhea), heartburn

59
Q

Most common side effects of TCAs

A

Antihistaminic (sedation, weight gain), anticholinergic (blurred vision, dry mouth, constipation, UR, tachycardia, decreased memory)

60
Q

Symptoms of a hypertensive crisis

A

Sudden, severe pounding headache, racing pulse, flushing, stiff neck, chest pain, n/v, diaphoresis

61
Q

Alpha 2 antagonist med

A

Remeron

62
Q

Alpha 2 ant side effects

A

Sedation, anticholinergic, appetite increase, weight gain, hypercholestremia, weak, lack of energy, dizzy, hypertriglyceridemia

63
Q

What is the least lethal antidepressant?

A

SSRI

64
Q

Common SSRI meds (5)

A

fluoxetine (Prozac), sertraline (Zoloft), paroxetine, escitalopram (Lexapro), citalopram (Celexa)

65
Q

Common side effects of SSRI

A

GI distress, sedation, weight loss/gain, anticholinergic, cramping, heartburn
-take w/food

66
Q

Common SNRI meds (4)

A

desvenlafaxine (Pristiq XR), duloxetine (Cymbalta), levomilnacipran (Fetzima), venlafaxine (Effexor XR)

67
Q

Common SNRI side effects

A

N/v, anticholinergic, weight gain, diaphoresis, sexual dysfunction
-watch for HTN, take w/food

68
Q

Common med for NDRI

A

Bupropion

69
Q

Side effects of trazodone (Oleptro)

A

Sedation, antichol, headache, dizzy, n/v

70
Q

Common TCAs

A

amitriptyline, clomipramine, amoxapine

71
Q

Common MAOIs

A

Isocarboxazid, phenelzine, tranylcypromine, selegiline

72
Q

Side effects for MAOI

A

Headache, drowsy, dry mouth, ortho hypoTN, insomnia, weight loss, rare priapism

73
Q

Side effects for TCAs

A

sedation, weight gain, anticholinergic, tachycardia, decreased memory
-take at bedtime, increase water and fiber, sugarless candy

74
Q

Serotonin syndrome

A

Develops within hours/days, s/s are AMS, agitation, myoclonus, hyperreflexia, fever, diaphoresis, ataxia, diarrhea.

75
Q

Nursing interventions for serotonin syndrome

A
  • stop using the drug
  • notify the provider
  • IV fluids, antipyretics, cooling blanket
76
Q

Cognitive therapy approaches are considered 1st line treatment and should be in all nursing care plans

A

Yes

77
Q

When depressed, increased energy can often be a sign of ….

A

Suicide plans

77
Q

When depressed, increased energy can often be a sign of ….

A

Suicide plans

78
Q

Milieu therapy

A

Helps maintain socialization skills and continue interaction with others

79
Q

Telehealth

A

Use of electronic approaches and communications that support Clincal and professional health care that facilitate biobehavioral health needs. Assess, diagnose, treat, collaborate

80
Q

Hypothyroidism is associated with depression

A

yep

81
Q

Medical home model

A

Health care coordinated by 1 health provider which allows for meaningful relationships

82
Q

Dysthymia

A

Persistent depressive disorder; major depression that lasts for 2 years if an adult or 1 year if a kid

83
Q

Premenstrual dysphoric disorder

A

Recurring mood swings, sadness, sensitivity to rejection in the final week before the onset of menses. Mood will improve a few days after menses begins. Stress, history of interpersonal trauma, and seasonal changes are associated

84
Q

Disruptive mood dysregulation disorder

A

Severe irritability and outbursts of temper. Begins before the age of 10, kids display outbursts 2-3 times a week and can occur with ADHD

85
Q

rTMS

A

Mild treatment resistant depression. 37 minutes, 20-30 session over 4-6 weeks

86
Q

ECT

A

Severe depression, rapid treatment needed, succinylcholine (muscle relaxant)

87
Q

Light therapy

A

Mild to moderate seasonal depression, non psychotic

88
Q

Trazadone (medication) should avoid what juice

A

Grapefruit

Psychosocial (5 decks)

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